KARACHI, Feb 25: Pancreatic transplantation provides a new lease of life to a diabetic and it is being carried out in many countries of the world as a revolutionary technique in surgery.

The observation was made by Surgeon Abrar Khan, the Chief Division of Transplantation, Surgery and Immunology, University of Vermont, in his presentation at the Sindh Institute of Urology and Transplantation here on Wednesday.

Dr Abrar said that the very transplantation could be a major requirement in the back drop of growing incidence of diabetes across the globe and particularly in the third world. He reiterated that diabetes was a common metabolic disorder, encountered in large numbers.

He said that pancreas transplantation was not as simple as other organs, because the donated pancreas could only be obtained from a brain dead donor or a cadaver.

He said that the beta cells or insulin producing cells in the pancreas were isolated and either injected into the portal vein or the main vessel of the liver or implanted on the bladder surface.

According to him, one patient usually requires the pancreas from two to three cadavers and the immuno-suppression drugs are given in higher doses. Pancreas and kidney were therefore usually done together.

Dr Abrar Khan described "Brain Death" as irreversible injury to the brain with the affected person being unconscious with a beating heart. To retrieve organs from a brain dead person, he stressed that it was necessary to have a legislation.

In most countries, the cadaver law was prevalent and organs including pancreas were removed after obtaining consent from the family of the deceased for transplantation in patients with failed organs. Unfortunately, there was no brain death law in Pakistan, he remarked.

He said that in order to advance the science of transplantation here, it was very importance that such a law be passed so that patients suffering from untreatable diseases could be cured by organ transplantation.

He stressed that the long-term complications associated with diabetes were devastating and were encountered as kidney failure, diabetic eye disease leading to blindness, nerve involvement causing foot ulcers and wounds eventually ending up in amputation, heart disease and strokes.

The speaker elaborated that diabetes was caused when the pancreas either stopped producing insulin altogether (Type One) or the amount of insulin was decreased in quantity (Type Two). He mentioned that insulin was a hormone that regulated the blood sugar levels and kept it in the normal range.

He said that lack of insulin increased the blood sugar level. The treatment, he added, was aimed at maintaining an optimal glucose control, either by helping the pancreas to produce more insulin by drugs that stimulated it or by replacing insulin via injections as in the Type One Diabetes.

"Although insulin injections replace the lacking insulin but they are not a substitute to abnormal functioning pancreas," he commented. However, he added, pancreatic transplantation provided a diabetic with a fresh lease of life.

Dr Abrar mentioned that pancreas transplantation was started about 40 years ago in the USA and it evolved as a science over the last few decades. At present, he added, pancreas transplantation could be done very successfully with 85 per cent of one year survival.

With a pancreas transplant, the blood sugar levels remained within the normal range, he said, and added that this not only provided a good quality of life, but also prevented further complications. - APP