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A 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 glucose levels.
Your 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.
You might be a good candidate for a pancreas transplant if:
People 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.
Some 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.
A 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.
Unfortunately, there is a long national waiting list for a pancreas transplant.
Occasionally, 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.
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.
As 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:
Before 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.
The procedure itself carries a number of risks, including:
The 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:
Since 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.
Most 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.
Talk 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 pancreas transplant.
Written by: Mary Ellen Ellis
Medically reviewed on: Mar 21, 2016: University of Illinois-Chicago, College of Medicine
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