Evolution of technique and results of pancreas transplantation at the University of Iowa

Recent experience with whole organ pancreatic transplantation in our institution has been encouraging. While early problems with cardiac‐related mortality and graft thrombosis occurred, normal carbohydrate metabolism has been achieved in over half the patients over a period of 1 to 2 years. Careful patient evaluation, including coronary arteriography, is expected to reduce mortality related to inappropriate patient selection. The incidence of graft thrombosis has been reduced by an anticoagulation protocol. Wound sepsis has been lessened by using bladder drainage rather than small intestine drainage. Opening of the peritoneum has been adopted so that serous drainage will be absorbed by the peritoneum. Two major problems remain; namely, the prevention of chronic rejection, and the question of whether secondary complications of diabetes can be stabilized or reversed.