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.