Annals of medicine
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Pancreatic transplantation for the treatment of diabetes mellitus in man has proved increasingly successful. Between December 1966 and August 1990 2735 pancreas transplants from 141 institutions were reported to the International Pancreas Transplant Registry. For the period 1986 to 1989 the one year graft survival rate in 1,200 patients was almost 70%, a significant improvement over the preceding five years. ⋯ On the other hand, it is established that pancreas transplantation may prevent the development of glomerular lesions in a simultaneously grafted kidney. Previously, transplantation of pancreas islets in man has not been successful. In 1990, however, in several insulin-dependent, diabetic subjects the intraportal transplantation of islets isolated from cadaver pancreas resulted in significant insulin production, and, in a few patients, it was possible to stop insulin treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Heart transplantation has evolved from an experimental procedure with a low survival rate to a therapeutic option for patients with end-stage heart disease. The most common diagnosis among recipients is cardiomyopathy, followed by coronary artery disease and vascular disease. ⋯ The number of suitable donors available is limited so we should ensure that donor's hearts go those patients who stand to gain the greatest benefit after operation. The cost-benefit ratio has been shown to be good and heart transplantation is nowadays a routine procedure in cardiac surgery.