Exceptional Outcomes for Pancreas Transplant Patients
A pancreas transplant may restore healthy insulin production and improve control of blood sugar in some people with type 1 diabetes and type 2 diabetes. The transplanted pancreas will produce the insulin the patient needs to maintain normal glucose levels without external insulin.
The original pancreas is not removed. You may want to consider a transplant if you have one or more of the following issues:
- Type 1 diabetics with or without renal disease can get a transplant
- Type 2 diabetics on insulin can be candidates for a pancreas transplant along with a kidney transplant
- You have kidney damage due to diabetes
- People with severe pancreatic exocrine insufficiency
A pancreas transplant can also be a treatment option for people with type 2 diabetes in selective cases. Loyola has an excellent reputation for performing pancreas transplants and providing follow-up care.
Please contact Loyola Medicine's transplant team to discuss your options.
Types of Pancreas Transplants
There are three different types of pancreas transplants:
- Pancreas alone transplant: This transplant is for patients with type 1 diabetes who have healthy kidney function but extremely difficult-to-control low blood sugar that gives no warning symptoms (hypoglycemia unawareness).
- Simultaneous pancreas-kidney transplant (SPK): This transplant is most commonly done when pancreas and kidney are transplanted at the same time from the same deceased donor. It will restore renal function and glucose control to prevent diabetic damage in the new kidney.
- Pancreas-after-kidney transplant (PAK): This transplant is for patients with type 1 diabetes or type 2 diabetes that already had a previous kidney transplantation. The organs come from different donors and will require two separate surgeries. Patients with a functioning kidney transplant who wish to stop their insulin may be candidates for this type of transplant surgery.
What Diseases are Treated with Pancreas Transplant?
Diabetes is a condition that occurs when your body has difficulty regulating your blood glucose (or blood sugar) levels and they become too high. Insulin, a hormone produced by the pancreas, helps glucose get from the food you eat to your cells to be used for energy.
If your body does not make enough insulin, glucose cannot get to your cells and it stays in your blood, raising your glucose level. Over time, high glucose levels can lead to diabetes as well as heart, kidney or eye disease, and a number serious health issues.
A pancreas transplantation is a potential treatment plan for those with type 1 diabetes, as it provides the insulin-producing cells and the blood glucose regulation that are lost with the disease. Transplantation will restore the normal pathway for glucose control in blood.
Pancreas transplantation may also be appropriate for patients with type 2 diabetes under specific conditions. Patients must be on insulin replacement therapy, have renal disease and have healthy body mass index (BMI).
After transplantation, there will be no need to receive insulin injections and blood sugar control will be normal. Pancreas transplantation can also help control damage to other organs due to the diabetes, such diabetic eye disease or vascular disease.
Evaluation and Wait List for Pancreas Transplants
The evaluation and waiting list process for pancreas transplantation includes medical, social, financial and surgical evaluations. Before the process starts, you will attend an education class and sign a consent for the evaluation.
First Step: Your Visit with Our Multidisciplinary Team
- Your transplant nephrologist and transplant surgeon with obtain medical information and do a physical examination to determine your current condition and request other testing.
- Your transplant coordinator will provide education about the process and coordinate your care during evaluation.
- Your pharmacist will go over all your current medications and inform you about the treatment required after transplant.
- Nutritional assessment
- Financial counselor
- Your social worker to assess your needs and support system to be able to maintain a healthy transplant.
Second Step: A Number of Tests Must be Completed
Once all the testing is completed, your case will be presented at the transplant review board, held every week. All the members of the team will review the testing and provide their opinion of your candidacy. The decision will be communicated directly to you and a copy will be sent to your doctor.
We will be there with you every step of the way, informing you of your test results and next steps.
Once you are on the list for a pancreas transplant, your Loyola team will make sure that you are up-to-date on all tests.
While you are waiting, you will continue to need periodical testing and blood work. We also will work with you on your exercise and dietary plans so that you are in the best possible condition once an organ match is available.
Pancreas Transplant Surgery and Recovery
When a pancreas becomes available, your medical team will quickly make the arrangements for your surgery and hospital stay. Your nurse coordinator will inform you and your family about where to go and when to arrive.
There will be several last-minute tests after your arrival at the hospital. Your surgery will take around three hours, and then you will start your recovery.
Transplant surgery is done via an incision in the midle of the abdomen, the pancreas is attached to the blood vessels in the pelvis on the right side and also connected to your intestine. The kidney is usually placed on the opposite side. You may need drains in the abdomen to collect excess fluid.
You will be closely monitored after surgery, and your nurses will be there to assess your pain and administer medication to make you comfortable. You should not need any insulin after the transplant, regardless of your food intake or exercise level. You will not experience low blood sugars either.
After your pancreas transplant, you will remain in the hospital for 7 to 10 days. Once you leave the hospital, you will require long-term follow-up treatment, including:
- Regular blood tests several times a week for the first two weeks to ensure your new organ is doing well
- Examination of your incision to ensure proper healing
- Regular monitoring for signs of organ rejection or infection
You will be prescribed immunosuppression medications to prevent transplant rejection. Your nurse coordinator will map out your lab tests and doctor visits to assess the function of your new organs.
You will have many appointments in the first year after surgery, but gradually your primary care doctor will start to take over your care. Complete recovery time varies from patient to patient, but most pancreas transplant patients are able to return to their studies or work after several months.
Should you ever have a question, your Loyola transplant care team is available around the clock.
Risks of Pancreas Transplant
A pancreas transplant does carry the risk of several complications:
- Bleeding
- Blood clots
- Fluid collections in the abdomen
- Infection
- Pancreas rejection
- Pancreas failure
- Pancreatitis
- Urinary tract complications
There is also a risk of side effects from the immunosuppressant medications:
- Osteoporosis
- Sensitivity to sunlight
- Skin puffiness
- Swollen gums
- Weight gain
Due to the fact that anti-rejection medications also suppress your immune system, your body may be more vulnerable to infection and disease.
