LD for pancreas transplantation

The first extrarenal organ to be successfully transplanted using living donors was the pancreas. The first pancreas transplantation using a living donor (LDP) was performed on June 20, 1979, at the University of Minnesota [1, 2]. Furthermore, successful simultaneous pancreas and kidney transplantation from a living donor (LDSPK) was started in 1994 also at the University of Minnesota [3]. The outcome of LDPs performed at the University of Minnesota demonstrated that the segmental pancreas was able to normalize plasma glucose levels and realize an insulin independency in the severe diabetic patients. The outcome of the donors was considered to be acceptable when using the stringent donor criteria concerning the endocrine function [4]. Based on a severe shortage of the deceased donors in our country and the satisfactory outcome of LDPs at the University of Minnesota, we have firstly introduced LDP (LDSPK) in our country on January 7, 2004 [5]. Eighteen LDPs (16 LDSPKs) have, so far, been performed in Chiba-East National Hospital. From 2007, we have introduced LDSPK from ABO-incompatible living donors according to our successful desensitization and immunosuppression protocol for ABO-incompatible kidney transplantation and performed, so far, six cases. In this chapter, we describe the criteria for living donation, historical background, and the prognosis for living donor from our clinical experiences of sixteen LDSPKs.