[Pancreas transplant].

Pancreas transplantation offers the possibility of preventing the development and progression of diabetic lesions by adequate control of hydrocarbon metabolism. Moreover, the diabetic patient is freed from dietary and physical restrictions, as well as from insulin treatment. However, this is achieved at the expense of an immunosuppression not always free of risk. For this reason, up to now, the transplantation has been reserved to those patients at a risk higher than that of immunosuppression: uremic patients who also require a kidney transplantation, patients suffering of preproliferative retinopathy, and those patients with urine protein above 150 mg/24 hours but less than 3 g/24 hours. The introduction of cyclosporine has greatly improved the transplantation results, achieving a 53% actuarial survival of the graft per year. Out of the different technics used, the one that yields best results is the transplantation of the whole organ, deriving the exocrine secretion to the urinary bladder. This method also enables early diagnosis of graft rejection by monitoring urine amylase.