Pancreas Transplant

What Is a Pancreas Transplant?

A pancreas transplant is surgery to implant a healthy pancreas from a donor into a person whose pancreas no longer works well, usually because of severe diabetes.

Severe type I diabetes is often linked to chronic renal (kidney) failure. As a result, a person who needs a pancreas transplant also may need a kidney transplant.

Types of Pancreas Transplants

The kinds of pancreas transplant operations include:

  • Combined kidney-pancreas transplant, in which a pancreas and kidney are transplanted during the same operation
  • "Pancreas after kidney" transplant, in which the pancreas is transplanted after a kidney has been transplanted
  • Pancreas transplant alone, in which only the pancreas is transferred; this is for patients with working kidneys.
  • Pancreatic islet cell transplant. Islets are groups of cells in your pancreas. Some of those cells, called beta cells, help make insulin, the hormone that helps turn blood sugar into energy. An islet transplant is still an experimental treatment and is done only in clinical trials. Doctors take healthy beta cells from donors and inject them into the veins of your liver.

Pancreas Transplant Candidates

A team of specially trained staff evaluates a person to determine whether they are a good candidate for a pancreas transplant. Typically only people with severe diabetes, usually type I or juvenile-onset diabetes, are considered.

If the person is considered a suitable pancreas transplant candidate, they will be placed on a waiting list. The evaluating team considers many things in deciding whether a person should be placed on the waiting list for a transplant. The person's general health and suitability for major surgery are taken into account. Pancreas transplants are not done on people with certain conditions, including:

  • Untreatable cancers
  • Infections that cannot be completely treated or cured, such as tuberculosis
  • Severe heart, lung, or liver problems or complications from diabetes that would make the operation too risky

What to Expect During a Pancreas Transplant

During pancreas transplant surgery, a donated pancreas is transplanted into the recipient, whose failed pancreas is not removed. The pancreas must be transplanted into the patient receiving the organ within hours after removing it from the donor. A team of surgeons and anesthesiologists does an operation to remove the pancreas from the donor. Other surgical teams may be present to remove other organs, such as kidneys.

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Before the procedure. Your doctors will test you over the weeks leading up to the transplant. Blood tests can look for infections and confirm that your blood type is a good match for the donor’s. X-rays, an echocardiogram, and other tests can look at your heart health.

During the procedure. You’ll get general anesthesia, so you won’t feel any pain or remember the operation. Your surgeon will cut through your skin down your belly. They will connect the healthy donated pancreas to your blood vessels. A small piece of the donor’s intestine will be attached to your intestine or your bladder. You’ll keep your own pancreas to help you digest food.

Pancreas Transplant Recovery

Here’s what you might expect after your surgery.

Spend a couple of nights in the intensive care unit.

Stay in the hospital a few more days in the regular recovery areas. The area around the cut on your belly might be sore or painful.

Get regular blood tests for a month or two.

Take anti-rejection medicine for the rest of your life. You’ll also need regular imaging and blood tests to monitor your new organ.

Your doctors also may ask you to stay near the transplant center for several months.

Pancreas Transplant Complications

Risks from a transplant. Any major surgery carries risks, including:

  • Blood clots
  • Bleeding
  • Infection
  • Inflammation of the new pancreas
  • Hyperglycemia
  • Urinary issues
  • Higher chance of certain cancers
  • Failure of the donated pancreas
  • Rejection of the donated pancreas

Side effects from anti-rejection drugs. You’ll take immunosuppressant medication for life. It may cause side effects, some of which can be serious. They include:

Signs of organ rejection. In about one in 100 people each year, the recipient’s body rejects the donated pancreas. This usually happens within days, weeks, or months after your transplant. But organ rejection can follow years after the surgery. Signs that your new organ isn’t working may include:

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on September 22, 2020

Sources

SOURCES:

National Institutes of Health: “Pancreatic Islet Transplantation,” “Pancreas transplant.”

Mayo Clinic: “Pancreas transplant.”

MedlinePlus: “Pancreas transplant.”

National Health Service (U.K.): “Pancreas transplant.”

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