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Pancreas transplantation would be easy if the recipients were not diabetic: A practical guide to post-operative management of diabetic complications in pancreas transplant recipients.

Abstract
Diabetes mellitus remains a major public health problem throughout the United States with over $300 billion spent in total cost of care annually. In addition to being a leading cost of kidney failure, diabetes causes a host of secondary hyperglycemic-related complications including gastroparesis and orthostatic hypotension. While pancreas transplantation has been established as an effective treatment for diabetes, providing long-term normoglycemia in recipients, the secondary complications of diabetes mellitus persist complicating the post-operative course of an otherwise successful pancreas transplantation. This review describes the mechanism and impact of diabetic gastroparesis and orthostatic hypotension in the post-operative course of pancreas transplant patients and analyzes the various treatment modalities, based on current data and extensive experience at our institution, to treat these respective complications. While gastroparesis and orthostatic hypotension remain challenging post-operative conditions, the establishment of institutional protocols and step-up treatment algorithms can help define more effective therapies.
AuthorsAdam Cerise, Jeanne M Chen, John A Powelson, Andrew J Lutz, Jonathan A Fridell
JournalClinical transplantation (Clin Transplant) Vol. 35 Issue 5 Pg. e14270 (05 2021) ISSN: 1399-0012 [Electronic] Denmark
PMID33644895 (Publication Type: Journal Article, Review)
Copyright© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Topics
  • Diabetes Complications
  • Diabetes Mellitus
  • Diabetes Mellitus, Type 1
  • Humans
  • Kidney Transplantation
  • Pancreas
  • Pancreas Transplantation

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