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Pancreas transplant

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Anonymous

14y ago
Updated: 11/10/2020
Definition

A pancreas transplant is surgery to implant a healthy pancreas from a donor into a patient with Diabetes. Pancreas transplants give the patient a chance to become independent of insulin injections.

Alternative Names

Transplant - pancreas; Transplantation - pancreas

Description

The healthy pancreas is obtained from a donor who has suffered brain-death, but remains on life-support. The donor pancreas must meet numerous criteria to make sure it is suitable.

A portion of the first part of the small intestine, called the duodenum, is transplanted along with the donor pancreas. The healthy pancreas is transported in a cooled solution that preserves the organ for up to 20 hours.

The patient's diseased pancreas is not removed during the operation. The donor pancreas is usually placed in the right lower portion of the patient's abdomen. Blood vessels from the new pancreas are attachmented to the patient's blood vessels. The donor duodenum is attached to the patient's intestine or bladder to drain pancreatic secretions.

The surgery for a pancreas transplant alone takes about 3 hours. However, the operation is usually done at the same time as a kidney transplantin diabetic patients with kidney disease. The combined operation takes about 6 hours.

Why the Procedure Is Performed

The pancreas makes a substance called insulin. Insulin moves glucose, which is sugar, from the blood into the muscles, fat, and liver cells, where it can be used as fuel. In people with type 1 diabetes, the pancreas doens't make enough, or sometimes any, insulin. This causes glucose to build up in the blood, resulting in high blood-sugar levels.

A pancreas transplant can cure diabetes and eliminate the need for insulin shots. Because of the risks involved, however, most people with type 1 diabetes do not have a pancreas transplant soon after they are diagnosed.

  • Pancreas transplant is major surgery, and people with diabetes have a high-than-normal risk of Heart disease and other complications.
  • People who've had a pancreas transplant will need to take several medicines for the rest of their lives. These medicines have serious side effects.

Because of these risks, pancreas transplant is rarely done alone. It is almost always done when someone with type 1 diabetes also needs a kidney transplant.

Pancreas transplant surgery may NOT be recommended for patients who also have:

  • A history of cancer
  • Infections such as hepatitis, which are considered to be active
  • Lung disease
  • Morbid obesity
  • Other types of blood vessel diseases of the neck and leg
  • Severe heart disease (such as heart failure, poorly controlled angina, or severe coronary artery disease)
  • Smoking, alcohol or drug abuse, or other lifestyle habits that can damage the new organ

The doctor may also recommend against pancreas transplant if there is concern that the patient will not be able to comply with the many follow-up visits, tests, and medications needed to keep the transplanted organ healthy.

Risks

The risks for any surgery are:

  • Bleeding
  • Breathing problems
  • Heart attack or stroke
  • Infection or abscess
  • Reactions to medications
  • Scar formation

The risks for pancreas transplant include:

  • Blood clots (deep venous thrombosis)
  • Clotting (thrombosis) of the arteries or veins of the new pancreas
  • Inflammation of the pancreas (pancreatitis)
  • Leakage of fluid from the new pancrease where it attaches to the intestine or bladder

The body's immune system considers the transplanted organ foreign, and fights it accordingly. Thus, to prevent rejection, organ transplant patients must take drugs (such as cyclosporine and corticosteroids) that suppress (weaken) the body's immune response . This makes the person less able to fight various infections and can cause other medical problems.

Before the Procedure

Patients undergoing pancreas transplant have chronic kidney disease along with their diabetes. Because of this, a very thorough evaluation for heart disease is done beforehand.

See Kidney transplant.

After the Procedure

See Kidney transplant.

Outlook (Prognosis)

If the transplant is successful, you will no longer need to take insulin shots, test your blood-sugar daily, or follow a diabetic diet.

There is evidence to suggest that the complications of diabetes, such as diabetic retinopathy, may not worsen -- and may even improve -- after a pancreas-kidney transplant.

Drugs that prevent rejection of the donated pancreas and kidney must be taken for the rest of the patient's life.

See Kidney transplant.

References

Lipshutz GS, Wilkinson AH. Pancreas-kidney and pancreas transplantation for the treatment of diabetes mellitus. Endocrinol Metab Clin North Am. 2007;36(4).

Markmann FJ, Yeh H, Naji A, et al. Transplantation of abdominal organs. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 28.

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14y ago

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Related Questions

What kind of transplant helps diabetics?

A pancreas transplant


How common is a pancreas-kidney transplant?

An additional 305 patients received a PAK, or pancreas after kidney transplant, according to the United Network for Organ Sharing (UNOS).


What should be discussed between patient and doctor prior to transplant surgery?

How many pancreas or pancreas-kidney transplants have both you and the hospital performed?What are your success rates?How about those of the hospital?Who will be on my transplant team?


What vitamin needs for pancreas?

yes you need a pancreas or you will have type 1 diabetes If you need you can always get a transplant :) FEEL BETTER


Who are not good candidates for a pancreas transplant?

Many people with diabetes are not good candidates for a pancreas transplant. Others do not have tissue compatibility with the donor organ. People who are successfully controlling their diabetes with insulin injections are usually not considered.


What can a pancreas transplantation restore in a type I diabetes patient?

In those patients with diabetes who will receive or are already receiving immunosuppressive treatment for a life-saving kidney transplant, a pancreas transplant can return their ability to self-produce insulin.


What are the survival rates for kidney transplant patients?

Survival rates for pancreas-kidney transplant recipients were 95.1% after one year and 89.2% after three years.


What is the percentage of pancreas transplants that are successful?

Pancreas transplants are often done with a kidney transplant, this is called an SPK (Simultaneous Pancreas Kidney) transplant and generally yields higher success than when the pancreas is transplanted alone. Nationally, the one-year success rate of combined pancreas/kidney transplants is 76 percent, but only about 50 percent of the pancreases transplanted without a kidney are still functioning after one year.


What improvements result following a pancreas transplantation?

In a successful transplant, the pancreas begins producing insulin, bringing the regulation of glucose back under control.


Can you get a pancreas transplant?

Yes, though there are a number of high risks involved including (but not limited to) rejection of the donor organ(s). Most pancreas transplants are done in conjunction with a kidney transplant as well. They're known as an SPK transplant. The rate of pancreatic health after 1 year is 90% and after 5 years is only 60%.


What is the survival rate for pancreas transplant patients?

In their 2002 Annual Report, the Organ Procurement and Transplant Network (OPTN) reported that the patient survival rate for pancreas transplant alone was 98.6% after one year and 86% after three years.


Can diabetes be cured with a organ transplant?

Yes it can. There are two types of diabetes, insulin dependant and non insulin dependant. Diabetes ends up affecting the kidney and eventually a kidney transplant will be required. Because diabetes is caused by the insulin production, in the insulin dependant diabetes, often a pancreas and kidney transplant will take place. The pancreas is where the insulin is produced. By replacing the pancreas, insulin production becomes normal and diabetes is cured.