Pancreas Transplantation: Surgical Techniques and Perioperative Management

Abstract Purpose of Review Pancreas transplantation is currently the only therapy that can reliably establish long-term glucose control independent of exogenous insulin administration. Since the introduction of pancreas transplantation nearly sixty years ago, outcomes have steadily improved in the ensuing decades secondary to a marked decrease in early technical allograft failures. Recent Findings This positive trend in outcomes is the consequence of advances in donor selection and management, organ retrieval and preservation, recipient selection and overall medical care, surgical techniques and perioperative management, diagnostic and interventional methodology, immunosuppression medications and strategies, and anti-infective prophylaxis. Summary In this review, surgical techniques for pancreas allograft implantation will be described, with a focus on the prevention, identification, and management of technical complications. Early post-operative management during the index hospitalization will also be discussed with an emphasis on anticipating and managing the sequelae of long-term diabetes that may complicate the immediate post-operative course.