Pancreas transplantation 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 which the pancreas stops producing the hormone insulin. The usual treatment for type 1 diabetes involves 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. The kidney transplant may be done earlier or even after the pancreas transplant.
In a pancreas transplant, your own pancreas remains in your body. The surgeon generally connects the new pancreas to your intestines so its digestive juices can drain. After a successful transplant, you’ll no longer need to take insulin. Instead, the new pancreas will create insulin for you. You can eat a regular diet, too. You’ll have few or no episodes of low (or very high) blood sugar or insulin shock and your risk for kidney damage will go down.
Who is a candidate for the transplant?
Candidates for pancreas transplantation generally have type 1 diabetes, usually along with kidney damage, nerve damage, eye problems, or another complication of the disease. Usually, healthcare providers consider a transplant for someone whose diabetes is out of control even with medical treatment. This is true especially when low blood sugar (hypoglycemia) has been a long-lasting problem. Select people with type 2 diabetes have received pancreas transplants as well. A pancreas transplant also works best on people without heart or blood vessel disease. If you choose a pancreatic transplant, you may be asked to stop smoking or lose weight before the surgery.
What are the risks?
The procedure’s risks are infection and organ rejection. Rejection happens when the body’s immune system attacks the new organ as a “foreign” invader. To reduce the chances of rejection, the healthcare team tries to match the blood and tissue type of the organ donor to the person getting the transplant.
After the transplant, healthcare providers prescribe special medicines that suppress the immune system, such as azathioprine and cyclosporine, to help prevent rejection of the new pancreas. However, these medicines make it more likely for people with a transplanted organ to pick up infections like colds and the flu. Over time, the medicines may also increase the risk for certain cancers. Because of the higher risk for skin cancer, for example, it’s important to cover up and wear sunscreen. If you get a pancreas transplant, you must take special medicines as long as you have the transplanted organ in your body. You will also need tests over the years to be sure that your pancreas transplant is still functioning adequately. It’s also crucial to keep all your healthcare provider appointments.
Is there a waiting list?
Currently, more people are in need of a healthy pancreas than can be provided for with donors. The wait for a pancreas can be quite long—on average, about 3 years. Surgeons may plan to do a pancreas transplant at the same time as a kidney transplant, to help control blood glucose levels and reduce damage to the new kidney. The chance of rejection is less if the immune characteristics of the donated organ match more and are capable of existing with those of the patient who receives the transplant.
What is the outlook after a pancreas transplant?
The long-term outlook for people who receive a pancreas transplant is quite good. People who receive simultaneous kidney-pancreas transplants also tend to have less chance of rejection. A positive long-term result depends on a number of factors including control of blood glucose.
March 22, 2017
Pancreas and Islet Transplantation in Diabetes Mellitus. UpToDate, Patient Selection for and Immunologic Issues Relating to Kidney-Pancreas Transplantation in Diabetes Mellitus. UpToDate, Sharples E. Challenges in Pancreas Transplantation. Acta Diabetologia. 2016.
Hurd, Robert, MD,Walton-Ziegler, Olivia, MS, PA-C