Dr Rainer Gruessner was appointed chair of the Department of Surgery
at the University of Arizona’s College
of Medicine in Tucson. He is an authority on transplant
options for patients with diabetes mellitus.
“Diabetes is usually considered a disease with a low quality of life,”
he says. “But it really is a very crippling, life threatening and
life-shortening disease.” Dr Rainer Gruessner states that diabetes is the most
common cause of leg amputations, blindness, kidney disease, and other
morbidities in the United
States. Diabetes affects about ten percent
of the population, over thirty million people.
“We have several different options to treat patients with diabetes
through transplantation,” Dr Rainer Gruessner says. “The first one is kidney
transplantation. Most of the patients with end-stage kidney disease, about
forty to fifty percent, have non-functioning kidneys as a result of diabetes.
If we do a kidney transplant, we correct the symptom of end-stage kidney
disease and achieve dialysis-independence.” The trouble with this option,
Gruessner continues, is that “a kidney transplant doesn’t do anything about the
diabetes, and there is a good chance the diabetes will recur in the
transplanted kidney later on and destroy it.”
To cure diabetes, Dr Rainer Gruessner says, surgeons have to
transplant the insulin-producing cells. “We can do that through two
mechanisms,” he says. “The first option is to transplant the entire pancreas
and the results are very good: more than 4 in 5 patients after a successful
pancreas transplant do not require any insulin and the progression of secondary
diabetic complications is halted or reversed. Some patients have been off
insulin for over 25 years after a successful pancreas transplant.”
Dr Rainer Gruessner says the other option is to transplant only the
cells that produce insulin. “However, the results of islet transplantation
trail those of pancreas transplantation and islet transplantation is currently
not covered by Medicaire/Medicaid or private insurance companies.”
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