pancreas transplant is considered a last resort treatment for people who have
type 1 diabetes. Type 1 diabetes occurs when the pancreas stops producing
insulin. The aim of a transplant is to restore normal blood glucose levels to
the body. The transplanted pancreas is able to produce insulin to manage blood
body needs insulin to help it take glucose from the bloodstream and put it into
your cells. Without insulin, glucose would stay in your bloodstream and cause
high blood sugar. If your blood sugar gets too high, or stays high for too
long, you can develop serious complications.
might be a good candidate for a pancreas transplant if:
diabetes treatments aren’t effective
- you frequently
experience low blood sugar, or insulin reaction
- you are having
difficulty controlling your blood sugar
- you have
severe kidney damage
who have type 2 diabetes are not considered candidates for a pancreas
transplant. This is because type 2 diabetes affects the way your body uses
insulin, not how much is produced.
people may have a pancreas transplant alone (PTA). People who are experiencing
diabetic nephropathy, or damage to the kidneys, will often receive a pancreas
and kidney in a procedure called simultaneous pancreas–kidney (SPK) transplant.
Who Can Be a Pancreas
pancreas donor is usually someone who has experienced brain death but remains
on a life support machine. This donor has to meet common transplant criteria
including being a certain age and otherwise healthy. The donor’s pancreas also
has to match immunologically with the recipient’s body. This is important to
help reduce rejection risk. Rejection occurs when the body’s immune system
reacts to the transplanted organ.
there is a long national waiting list for a pancreas transplant.
pancreatic donors are living. This may happen if you can find a donor who is a
close relative, such as an identical twin. A living donor gives part of their
pancreas, not the whole organ.
How Is a Pancreas
A PTA procedure takes
around three hours. This procedure is carried out under general anesthesia,
meaning that you will be unconscious throughout.
To remove the pancreas
from the donor, the surgeon will remove the pancreas and an attached section of
the small intestine.
The surgeon will make a cut
down the center of your abdomen and place the new pancreas and small intestine
section in the lower abdomen. The surgeon will then attach the new section of
intestine to your small intestine or bladder and attach the donor pancreas to your
blood vessels. Your existing pancreas will remain in your body.
Surgery takes longer if a
kidney is also transplanted via a SPK procedure. The surgeon will attach the
new kidney to the bladder and blood vessels and, if possible, will leave the
existing kidney in place.
After your transplant, you
will stay in the intensive care unit for the first few days to allow close
monitoring for any complications. After this, you will most likely be moved to
a transplant center for further recovery. This is a dedicated center for people
who received an organ transplant. A pancreas transplant involves many
medications. You will be placed on medications that suppress your immune system
to prevent your body from rejecting the donor pancreas. Your drug therapy will
require extensive monitoring, especially as you will remain on a number of
these drugs for life.
Are There Any Risks?
with any organ transplant, a pancreas transplant carries the possibility of
rejection as well as failure of the pancreas itself. Experts aren’t sure why,
but your survival rate is different depending on if you also receive a kidney
transplant. After one year, survival rates are:
- about 85 percent
in people who had a simultaneous pancreas-kidney transplant
- about 82 percent
in people who had a pancreas after kidney transplant
- about 76 percent
in people who received a pancreas-only transplant
agreeing to this procedure, you and your doctor will have to weigh the long-term
benefits and risks of transplant against the potential mortality and
complications associated with diabetes.
procedure itself carries a number of risks, including:
- blood clots
- high level of
blood glucose, or hyperglycemia
drugs given to suppress your immune system after the transplant can also cause
serious side effects, and you will have to take many of these drugs for life.
Side effects include:
- blood pressure
- thinning bones
- excessive hair
- weight gain
susceptibility to infection
What Is the Outlook for Someone Who Gets a
the first pancreas transplant, there have been many advances in the procedure.
One of the biggest improvements is the donor selection process. Picking donors
that are better matches to the recipient reduces the risk of organ rejection.
people who receive a pancreas transplant say that they have a better quality of
life. One study interviewed people several years after their transplant and 95 percent said that
managing immunosuppressant drugs was easier than managing diabetes.
to your doctor if you’re having difficulties managing your diabetes with
standard treatments. They can help you decide if you are a good candidate for a