Diabetes e transplante de pâncreas / Diabetes and pancreas transplant

Os autores fazem uma revisão sobre transplante de pâncreas em pacientes diabéticos

Experiencia inicial con trasplante de páncreas e islotes asociado a trasplante renal en pacientes diabéticos / Clinical experience with pancreas and islet transplantation in diabetes patients treatment

Antecedentes: El trasplante de tejido pancreático es en la actualidad el sistema más fisiológico de aporte de insulina en pacientes diabéticos. Objetivo: Presentar los resultados con el trasplante de páncreas vascularizado e islotes en pacientes diabéticos. Diseño: Retrospectivo y discutido. Material y métodos: En un período de tres años se efectuaron 5 trasplantes de páncreas vascularizado y 3 trasplantes de islotes en pacientes diabéticos tipo I. Se evaluaron variables bioquímicas y clínicas de seguimiento postrasplante. Resultados: No se registró mortalidad postoperatoria. Dos pacientes fallecieron al 4º y 14º mes. El resto están vivos y con función de sus órganos a 22, 10 y 9 meses postrasplante en el caso de trasplante vascularizado. En el caso de islotes trasplantados mejoró notablemente el manejo metabólico, bajando los requerimientos diarios de insulina. Conclusión: El trasplante vascularizado de páncreas sigue siendo la mejor opción terapéutica, para revertir completamente la insuficiencia endocrina. El trasplante de islotes ofrece un menor riesgo y puede ser implementado en una población altamente seleccionada

Situación actual de los trasplantes de órganos en Chile / Organ transplantation in Chile: current situation

In Chile, the experience in organ transplatation began in the sixties with renal transplantation. Since then, a great progress has been made in terms of number of transplants, performance of extrarenal transplants (liver and to a lesser extent, heart), organ procurement and increasing the access of adult and pediatric patients to these complex and expensive procedures. Transplantation has become widely accepted as the therapy of choice for end stage organ failure and we have acquired considerable experience in the fields of renal and liver transplantation. These improvements have been the result of the great efforts made by transplant groups but the financial support provided by public health authorities has also contributed to the success. In the near future, organ transplantation will most likely continue to progress in our country, specially in the area of thoracic organs, but the still is a good deal of work to be done. In the forthcoming years, we will face the challenge of maintaining high quality levels with tremendous financial restrictions. We are optimistic that we will continue to improve our skills and experience as in the last decade and organ transplantation will become a widely available therapy with high standards of results