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April 29, 1974

Pancreatic Transplants: New Wrinkles

JAMA. 1974;228(5):609-610. doi:10.1001/jama.1974.03230300049033

The discovery of insulin by Banting and Best some 50 years ago was an unmitigated blessing, almost a miracle, for thousands of diabetics who would have died without it. During this half century, however, it has been recognized that injections of the beneficient fluid fall short of being the ultimate treatment. Not only are syringes and needles an onerous nuisance, but insulin, which certainly prolongs life, has failed to prevent premature deaths from vascular disease, perhaps because its intermittent administration cannot mimic the on and off response to physiologic demand that the pancreas provides.

In these circumstances, it was logical to consider transplanting the pancreas into insulin-requiring diabetic patients. Attempts made in animals, however, beginning more than 20 years ago, met with little success. With the advent of immunosuppressive agents, the bold were further emboldened to perform the operation on human subjects. The latest available data1 show that, by