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What is a pancreas transplant?
A pancreas transplant is the surgical placement of a donated human pancreas into your body. This is often done for severe type 1 diabetes.
Because people with diabetes often have kidney problems, sometimes a pancreas and kidney are transplanted together. Success rates have been shown to be higher in these patients as opposed to pancreas-only transplant patients. A 2003 study in the Journal of the American Medical Association found that people with functioning kidneys did better managing their diabetes with conventional therapy (e.g. insulin) than with a pancreas transplant.
When a whole pancreas isn't available from a donor bank, your doctor may suggest using a portion of a pancreas from a living relative. This is called a partial pancreas transplantation.
Why does a pancreas need to be replaced?
One of the main purposes of the pancreas is to make insulin, which controls our blood sugar levels. We can't live without insulin.
You probably know someone who has diabetes. There are two types of diabetes: type 1 and type 2. Most people have type 2.
In type 1 diabetes, the pancreas stops making insulin. People with type 1 diabetes need to give themselves insulin shots to stay alive.
Some people have such severe forms of type 1 diabetes that they need pancreas transplants. The new pancreas makes insulin, and the diabetes gets cured. Insulin shots and glucose testing will no longer be necessary.
However, a transplant is not easy, and you'll have to take even more medicine after the surgery to prevent rejection. If the transplant is rejected - as happens in half of all cases - you will get diabetes again.
How is a pancreas transplant performed?
If you need a pancreas transplant, you're first put on a waiting list. The United Network for Organ Sharing directs where the donated organs go.
Sometimes, a living donor may donate a partial pancreas. This means that a piece of pancreas is donated while the other part remains in the donor.
As you're waiting for a new pancreas, your doctors will order blood tests and x-rays.
There are three main types of transplants:
- Pancreas alone: Only the pancreas is transplanted.
- Pancreas and kidney together: Both a pancreas and kidney are transplanted at the same time.
- Pancreas after kidney: A pancreas is transplanted in someone who's already had a kidney transplant.
Any type of pancreas transplant is a major operation. After you're put to sleep (under general anesthesia), your lower abdomen is opened up and the new pancreas is put in. The donated pancreas gets connected to blood vessels and parts of your intestine or bladder. Your own pancreas is usually left in place.
Sometimes, people get a pancreas and kidney transplanted together.
How long does the procedure take?
The operation usually takes several hours. If you've had any type of stomach surgery before, the operation can take much longer.
What are the risks?
If you have serious heart or blood vessel disease, your doctor may advise against a transplant. Like any other major surgery, there is always a risk for bleeding, infection and death with a pancreas transplant. One to two people in 10 die within a year of getting a pancreas transplant, according to the American Diabetes Association.
Your body may also reject the new organ. This happens when your body's immune system starts attacking the organ. The new pancreas may stop working and you could end up waiting for a replacement.
You'll be given many different types of medicines after a transplant, which you'll need to prevent rejection. Each medication has side effects and risks. If you have had a kidney transplant as well, you are already taking the immunosuppressive medication so the risk isn't greater.
If you'll be having a pancreas transplant, it's very important to find a good transplant center that has a record of doing many successful transplants.
This article was reviewed and updated June 2007.
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