Treatment of Pancreatic Exocrine Disorders by Pancreas and Islet Transplantation

Pancreas transplantation is mostly performed to cure diabetes mellitus. However, patients with chronic pancreatitis, cystic fibrosis, benign pancreatic tumors, or patients with other exocrine disorders of the pancreas can also be candidates for a pancreas transplant in combination with a kidney, liver, or lung or for a pancreas transplant alone. With improvement in surgical techniques and immunosuppressive therapy, pancreas transplant outcomes have improved significantly over the past decade. Mounting evidence supports pancreas transplantation for the treatment of exocrine disorders as an important therapeutic option to restore both endocrine and exocrine function of the pancreas. Patient and graft survival rates are similar to those for pancreas transplants in diabetic patients. A successful pancreas transplant is also more cost efficient and puts less burden on health care spending. However, the risk of immunosuppression and surgery should be carefully evaluated and discussed with the patient. In this chapter, we discuss pancreas transplantation for pancreatic exocrine disorders: indications, other treatment options, and outcomes.