Life after pancreas transplantation: Reversal of diabetic lesions

PURPOSE OF REVIEW: Recipients of pancreas transplantation bear the burden of chronic complications of diabetes, both microvascular and macrovascular. Pancreas transplantation provides the most effective method of glycemic and metabolic control. As transplantation provides immediate relief from acute complications of diabetes, the impact of a successful transplant on long-term complications is the focus of this review. RECENT FINDINGS: It is increasingly recognized that a successful pancreas transplant may slow, stabilize, or ameliorate the progression of macrovascular and microvascular complications of diabetes. New understanding of the genetic and epigenetic mechanisms and pathophysiology of diabetic complications has provided new data potentially useful for prospectively studying the effect of pancreas transplant on chronic complications of diabetes. SUMMARY: Earlier correction of diabetes by pancreas transplantation decreases chronic complications. Refinements in the understanding of the tissue targets of diabetes complications and new diagnostic and imaging tools to measure them may prove useful in further studying the impact of pancreas transplantation on chronic complications of diabetes.