Milestones in Pancreas Transplantation in Belgium

Abstract

Currently, the burden and opportunity for successfulpancreas transplantation is regularly based on theexperience of the transplant team and mostly surgeonswho pioneered that field.Insulin independence in a type 1 diabetic patient wasfirst achieved on December 17, 1966 when WilliamKelly and Richard Lillehei transplanted a duct – ligatedsegmental pancreas graft simultaneously with a kidneyfrom a cadaver donor into a 28-year-old uremic womanat the University of Minnesota (1). Today, 40 years later,more than 25.000 transplants have been performedworldwide (2). According to the International PancreasTransplant Registry (IPTR), more than 90% of thepancreatic grafts are still functioning after 1 year, for allthree categories of transplants i.e. simultaneous pancreasand kidney (SPK), pancreas after kidney (PAK) andpancreas transplantation alone (PTA). Despite the fact that heart beating donation was firstused in Belgium in 1963 and opened the field ofmultiple organ procurement in deceased donors andsimultaneous transplantation in recipients (3), one hadto wait until 1982 to have the first double transplantationin Belgium, either heart and lungs transplantation (4) orSPK (3).Since 1982, all seven Belgian transplantation centersstarted a pancreas program, took different attitudesand followed specific protocols according to differentsurgical and medical backgrounds. The influence ofBelgian and International Pioneering Leaders was obvious.During the 25 years of Pancreas Transplantationanniversary meeting, which was hold at the Palais desCongres, in Liege, Belgium (November 14-15, 2007),those leaders highlighted their experience which leadedto current, outstanding results in pancreas transplanta-tion. Surgical techniques, contemporary immunosup-pressive regimens, and the latest results of beta cellreplacement therapy were the focus of that hallmarksymposium, with special attention on future perspec-tives. From the past to the future !