To many people, the obvious approach would seem to be simply to transplant pancreases from cadavers in the same manner that kidneys and other organs are routinely transplanted. That was the rationale in 1966 when the first recorded pancreas transplant was performed. Between 1966 and 1975, there were forty-six pancreas transplants in forty-five other patients in the United States and five other countries. But only one of these patients is still alive with a functioning graft, and surgeons have found that the procedure is not as simple as they once thought.
The surviving patient has required no insulin since the operation. Another patient survived 638 days without requiring insulin. And one patient survived a transplantation for more than a year, but died when he chose not to take the immunosuppressive drugs. These results, though meager, suggest that the procedure has the potential for success.
The rest of the patients, however, either rejected the transplant or died within a short period. There does not appear to be any technical problem with the procedure. Rather, most of the patients were already so severely debilitated by the complications of diabetes that they could not withstand the surgery and the immunosuppressive regimen required to prevent rejection. More than half of the patients, furthermore, also required a kidney transplant. Most investigators now agree that the simultaneous transplantation of both organs is too great a shock to the patient and greatly increases the total risk.
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