Organ Transplant

Pancreas Transplant

Description

Pancreas transplant refers to the surgical procedure of replacement of a pancreas that no longer works properly with a healthy one provided by a deceased donor. The pancreas lies in the lower back part of the stomach that creates insulin, which is responsible for absorption of glucose into the cells. If the pancreas does not develop adequate amount of insulin, it can increase the sugar level in the blood, causing type 1 diabetes. In such cases, pancreas transplant allows the person to get relief from serious diabetes symptoms. In some cases, pancreas transplant may also be performed with kidney transplant where the person’ kidneys are also damaged by diabetes.

The surgery is highly effective in treating type 1 diabetes and type 2 diabetes and very low blood sugar level (hypoglycemia).

Types of pancreas transplant

  • Pancreas transplant Alone (PTA), where the only pancreas of the patient is replaced
  • Simultaneous pancreas-kidney transplant (SPK), where both pancreas and kidney are replaced simultaneously due to diabetic nephropathy.
  • Pancreas after kidney transplant (PAK), where kidney is replaced before the pancreas.
  • Kidney after pancreas transplant (KAP), where the pancreas is replaced before the kidney.
  • Before the transplant, your doctor will perform various medical tests such as physical examination, CT scan, MRI, blood tests, urine tests and ultrasound, and instruct you with some guidelines that you need to follow a week before the surgery. On the day of the surgery, you will be given general anesthesia in order to put you to deep unconsciousness.

    Once you are asleep, the surgeon will create an incision in the center of your stomach to access the pancreas. He/she will then remove the connections between the intestine and pancreas. If you are having a kidney transplant as well, the surgeon will also remove the blood vessels that connect the kidney to the small intestine and the bladder. Once the pancreas is removed, the new and healthy pancreas given by the donor is placed in the same location and the donor intestine is also connected to your small intestine or bladder. Blood vessels will be attached to the donor pancreas that will also supply blood to the legs.

    If kidney transplant is also need to be done, the blood vessels of the donor kidney will be attached to the blood vessels of lower abdomen parts. During the entire process, the health care team will deeply monitor your vital signs such as heart rate, blood oxygen and blood pressure through heart monitor and blood pressure cuff. Once the transplants are complete, the incisions will be closed with stitches and staples. The whole procedure lasts for 2-4 hours, however, if you are having kidney and pancreas transplant, it can take some extra hours.

    Complications

    Pancreas transplant involves some side effects that differ from patient to patient, depending on the type of transplant done and the severity of the condition. Some of the most possible complications are:

    • Rejection by the immune system that consider the new pancreas as a foreign substance
    • Blood clots
    • Inflammation
    • Shortness of breath
    • Infection
    • Bleeding
    • High blood pressure
    • Osteoporosis (thinning of bones)
    • Excessive hair growth
    • Weight gain
    • High cholesterol
    • Digestive issues
    • Urinary issues
    • Nausea and vomiting
    • Diarrhea

    Post operative care

    After the procedure, you will be moved to the recovery room and the nurse will observe your condition thoroughly for complications. The new pancreas will begin working at once and if you had a kidney transplant as well, it will begin creating urine just the your old kidney. However, in some cases, this can take a while for normal urine production. You will have to spend at least a week in the hospital and once you are relieved from pain or other mild complications, you can go home.

    Although, you will have to come for frequent checkups in order to have a healthy recovery. The doctor will perform urine tests along with other examinations to make sure your pancreas is working properly.

    It is necessary to take all the medications as prescribed, especially immunosuppressant medications, which you will have to take for the rest of your life.

    Lead a healthy life with a balanced diet along with fruits and vegetables, and perform exercise to stay fit. Limit your caffeine and alcohol consumption and drink a lot of water.