Transplantation for the treatment of insulin-dependent diabetes: Clinical experience with polymer-obstructed pancreatic grafts using neoprene

We performed 45 pancreatic transplants in 43 insulin-dependent diabetics through October, 1983. In 11 cases the pancreas was transplanted alone; in 2 cases it preceded and in 1 case it followed a kidney transplant; and in 31 cases pancreas and kidney were transplanted simultaneously. Forty- four transplants were segmental, while in 1 case the pancreas was transplanted whole. The handling of the exocrine secretion was obtained through the duct occlusion technique by neoprene injection. The overall patient survival rate was 84.8%, 73.9%, 64.5%, 50.3%, and 35.0% at 3, 6, 12, 24, and 36 months, respectively. The overall pancreatic graft survival rate was 49.0%, 38.9%, 22.1%, 14.7%, and 7.4% at 3, 6, 12, 24, and 36 months, respectively. The survival rate for the pancreas transplanted simultaneously with kidney was 63.7%, 52.0%, 35.7%, and 23.8% at 3, 6, 12, and 24 months, respectively. Thirty-four pancreatic grafts (76%) failed due to: rejection (31%), death of the patient (27%), vascular thrombosis (16%), and local infection (2%), while 11 pancreatic grafts (24%) are currently functioning up to 31 months.