Pancreas Transplant
A pancreas transplant is a type of surgery in which you receive a healthy donor pancreas.
A pancreas transplant is a choice for some people with type 1 diabetes. Type 1 diabetes
is an autoimmune disease. In this disease, the pancreas doesn't make the hormone insulin.
The usual treatment for type 1 diabetes is daily injections of insulin.
During a pancreas transplant, you’ll receive a healthy pancreas from a donor who has
died. If you have kidney failure from your diabetes, your surgeon may also do a kidney
transplant at the same time. Or the kidney transplant may be done earlier or after
the pancreas transplant. Sometimes a living person will donate part of their pancreas
for transplant.
In a pancreas transplant, your own pancreas stays in your body. The surgeon connects
the new pancreas to your intestines or to your urinary bladder. This is so its digestive
juices can flow right into your intestines or into your bladder. After a successful
transplant, you may no longer need to take insulin to control your blood sugar. Instead,
the new pancreas will create insulin for you. You may be able to eat a regular diet,
too. In addition, you will likely have few or no episodes of low (or very high) blood
sugar. Your risk for kidney, eye, and nerve damage will also likely go down.
Pancreas islet cell transplant is another option. Islet cells are the cells in your
pancreas that make hormones, including insulin. Experimental clinical trials are underway
to find out if an islet cell transplant will work to treat diabetes. So far, trials
have shown that an islet cell transplant is simpler and less invasive than a pancreas
transplant, but it doesn't work as well. Advances have been made in using stem cells
as a treatment. These are cells in the body that can be programmed to form certain
types of cells. In this case, the stem cells form islet cells.
Who is able to have a pancreas transplant?
Most pancreas transplants are done for people who have type 1 diabetes. They will
likely also have other problems due to diabetes. These include kidney damage, nerve
damage, eye problems, or other problems. Or, healthcare providers may allow a transplant
for someone whose diabetes is out of control even with medicine. This is often the
case when low blood sugar (hypoglycemia) has been a long-lasting problem. Some people
with type 2 diabetes may be able to qualify for a pancreas transplant. A pancreas
transplant also works best on people without heart or blood vessel disease. If you
choose a transplant, you may be asked to stop smoking or lose weight before the surgery.
What are the risks of a pancreas transplant?
The main risks are infection and organ rejection. Rejection is when the body’s immune
system attacks the new organ as a “foreign” invader. To reduce the chances of rejection,
the healthcare team matches the blood and tissue type of the organ donor to the person
getting the transplant.
You'll also receive special medicines to prevent rejection. You need to take these
medicines as long as the organ is in your body. These medicines suppress the immune
system. The medicines also make it more likely for you to pick up infections like
colds and the flu.
Over time, the medicines may increase your risk for some types of cancer. This includes
a higher risk for skin cancer. Because of this, it’s important to cover up in the
sun and wear sunscreen.
Is there a waiting list for a pancreas transplant?
There are more people in need of a healthy pancreas than there are donors. The wait
for a pancreas can be quite long. On average, it may take about 2 to 3 years. Surgeons
may plan to do a pancreas transplant at the same time as a kidney transplant. This
is done to help control blood glucose levels and reduce harm to the new kidney. The
chance of rejection is less if the immune type of the donated organ matches well with
your body.
What are the results after a pancreas transplant?
The long-term results for people who have a pancreas transplant are good. People who
have kidney-pancreas transplants also tend to have less chance of rejection. A good
long-term result depends on a number of factors. This includes control of your blood
sugar. You will need tests over time to make sure that your pancreas transplant is
still working well. It’s vital to keep all your healthcare provider appointments.