Should We Be Performing More Pancreas Transplants?

Pancreas transplantation can provide insulin independence, improved survival, and improved quality of life for patients with diabetes mellitus. However, there has been a steady decline in the number of pancreas transplants (either alone or with a kidney) performed in the United States over the past decade. This decline has occurred despite a steady increase in the number of diabetic patients with end stage renal disease on the kidney transplant alone waiting list. This paper will review the current status of pancreas transplantation, suggest possible explanations for the declining numbers of transplants, highlight current gaps in knowledge, and suggest possible future studies and developments aimed at increasing the application of this effective therapy.