The use of cyclosporine in renal and pancreas transplantation.

Pancreas transplantation started in December 1966 at the University of Minnesota but the number of transplants eventually increased in the early 1980s for two main reasons: the refinement in surgical techniques and the advent of cyclosporine. In that period, we moved from segmental grafts (duct injection, open-duct, pancreaticojejunostomy on a Roux-en-Y loop) to whole pancreaticoduodenal transplants with bladder and enteric drainage of the exocrine secretion. Despite its toxic effect at high dosage, cyclosporine was the basic immunosuppressive therapy and helped to develop the principle of the combination therapy as well as the pancreas transplantation field. Today, simultaneous pancreas and kidney transplantation is the gold standard procedure for end-stage type 1 diabetic nephropathy recipients.