Pancreas transplant for Type 2 DM
In the appropriately selected type 2 diabetic patients, pancreas transplant can be a valuable treatment option. Type 2 DM account for 8-10 % of SPK transplants performed worldwide and only 5% of PAK and 1% of PTA transplants are performed in this setting.
For pancreas transplant, ideal T2DM candidate is insulin-dependent, suffers from nephropathy, lean and has few to no comorbidities. He should have :
Age < 65 years
Renal insufficiency with an eGFR less than 20 mL/min or dialysis dependence
Insulin dependence
C-peptide level greater than 2 ng/mL with a body mass index (BMI) of less than 30 kg/m2
Relatively low insulin requirement <1 Unit/kg/day (i.e no evidence of severe insulin resistance)
He should not be morbidly obese with mild-moderate co-morbidities only
Simultaneous pancreas – kidney (SPK) transplants are done for type 2 diabetes mellitus patients
