The number of pancreas transplants reached 16,043 worldwide in October 2001, with 1800 performed in 2000. Since the introduction of
cyclosporine (CyA) in 1979, a regimen consisting of CyA,
azathioprine, and
steroids has been shown to improve long-term survival of clinical transplants. In Japan, the first simultaneous pancreas-
kidney transplantation was performed in 1984, using organs from a
brain-dead donor. This procedure was followed by 14
pancreas transplantations from
cardiac arrest donors. All cases utilized a CyA-based regimen with
antilymphocyte globulin or
OKT3 induction. Six of the 15 recipients required less
insulin postoperatively. Under a new transplant law enforced in 1997, 10 pancreas/pancreas-
kidney transplantations were performed in patients diagnosed with
end-stage renal failure due to
diabetes mellitus type 1. In 1 patient, the graft failed due to
venous thrombosis, but the other 9 recipients achieved an increased quality of life without the need for
insulin or for dialysis.
Pancreas transplantation represents an effective treatment worldwide and in Japan, due to the availability of CyA or
tacrolimus in combination with other agents such as
antilymphocyte globulin,
OKT3, or
mycophenolate mofetil. This investigation presents the results of pancreas-
kidney transplantation in Japan, in comparison with those worldwide, and describes a recent case in Japan.