Transplantation of the whole pancreas is rare, due in part to the few available donor organs, and to the need for lifelong immunosuppressive therapy to prevent transplant rejection. The American Diabetes Association recommends pancreas transplant only in people who also require a kidney transplant, or who struggle to perform regular insulin therapy and experience repeated severe side effects of poor blood sugar control. Most pancreas transplants are done simultaneously with a kidney transplant, with both organs from the same donor. The transplanted pancreas continues to function for at least five years in around three quarters of recipients, allowing them to stop taking insulin.Transplantations of islets alone have become increasingly common. Pancreatic islets are isolated from a donor pancreas, then injected into the recipients portal vein from which they implant onto the recipients liver. In nearly half of recipients, the islet transplant continues to work well enough that they still dont need exogenous insulin five years after transplantation. If a transplant fails, recipients can receive subsequent injections of islets from additional donors into the portal vein. Like with whole pancreas transplantation, islet transplantation requires lifelong immunosuppression and depends on the limited supply of donor organs; it is therefore similarly limited to people with severe poorly controlled diabetes and those who have had or are scheduled for a kidney transplant. Pathogenesis
Type 1 diabetes is a result of the destruction of pancreatic beta cells, although what triggers that destruction remains unclear.
A myxoma is a rare benign tumor of the heart. Myxomata are the most common primary cardiac tumor in adults, and are most commonly found within the left atrium near the valve of the fossa ovalis. Myxomata may also develop in the other heart chambers. The tumor is derived from multipotent mesenchymal cells. Cardiac myxoma can affect adults between 30 and 60 years of age. Signs and symptoms
Symptoms may occur at any time, but most often they accompany a change of body position. Pedunculated myxomata can have a "wrecking ball effect", as they lead to stasis and may eventually embolize themselves. Symptoms may include:
Shortness of breath with activity
Platypnea – Difficulty breathing in the upright position with relief in the supine position
Paroxysmal nocturnal dyspnea – Breathing difficulty when asleep
Dizziness
Fainting
Palpitations – Sensation of feeling your heart beat
Chest pain or tightness
Sudden Death (In which case the disease is an autopsy finding)The symptoms and signs of left atrial myxomata often mimic mitral stenosis. General symptoms may also be present, such as:
Cough
Pulmonary edema – as blood backs up into the pulmonary artery, after increased pressures in the left atrium and atrial dilation
Hemoptysis
Fever
Cachexia – Involuntary weight loss
General discomfort (malaise)
Joint pain
Blue discoloration of the skin, especially the fingers change color upon pressure, cold, or stress (Raynauds phenomenon)
Clubbing – Curvature of nails accompanied with soft tissue enlargement of the fingers
Swelling – any part of the body
Presystolic heart murmurThese general symptoms may also mimic those of infective endocarditis.