History of pancreas transplantation

Since the first pancreas transplant by Kelly and Lillehei on December 17, 1966, > 50, 000 pancreas transplants have been performed worldwide. The evolution of pancreas transplantation from an experimental to a standard surgical procedure took decades and included improvements in surgical techniques, immunosuppressive regimens, polymicrobial therapy, and posttransplant care, and follow-up. Many transplant surgeons have contributed to the now standardized technique of whole-organ pancreaticoduodenal transplantation with systemic venous and enteric drainage. Antibody induction therapy and triple maintenance immunosuppression have become standard of care. Despite improvements in exogenous insulin therapy through advanced medical devices and attempts at islet transplantation, pancreas transplantation remains the only long-term treatment option for patients to become insulin-independent and normoglycemic. Over the past few decades, a plethora of literature has shown that pancreas transplantation not only achieves freedom from insulin but also cessation and even reversal of secondary diabetic complications.