[Effect of the choice of recipient, surgical technic and logistics on the Zurich results of pancreas transplantation].

Simultaneous pancreas and kidney transplantation was applied to 22 type-I diabetics with diabetic nephropathy and other secondary complications, between July 1st, 1980 and November 30th, 1985. Four pancreas transplants, at present, are functional 56, 25, 15, and twelve months from transplantation. Six transplants lost their function within one and a half to 61 months from transplantation. The transplanted kidneys were immunologically rejected in four of these six cases. Four patients died with functioning transplants between 36 hours and eight months from transplantation. Three of them died of cardiac secondary sequels of their primary disease. In nine cases, pancreas transplants lost function within one month from transplantation without affecting functions of simultaneously transplanted kidneys. Most of the functional failures of transplants had been caused by ischaemic damage and postoperative vascular thrombosis. Complications from the exocrine pancreas were eliminated or avoided by postponement of percutaneous duct occlusion, using prolamine. The results reported in this paper show that for juvenile diabetics with nephropathy and ophthalmopathy simultaneous pancreas and kidney transplantation is the method of choice, whereas the course of the disease in patients with advanced secondary complications, such as severe angiopathy and gastropathy, could not be decisively improved by pancreas transplantation.