Pancreas Transplant

What is a pancreas transplant?

A pancreas transplant is an operation to replace a diseased pancreas with a healthy one from a deceased donor.

Who needs to have a pancreas transplant?

Pancreas transplantation treats severe, long-term, uncontrolled Type 1 diabetes, also called insulin-dependent diabetes.

Your pancreas is an organ behind your stomach. It produces insulin, a hormone that helps your body use sugar (glucose) for energy. In Type 1 diabetes, the pancreas makes little to no insulin. People with Type 1 diabetes must inject insulin to help control blood glucose levels.

Sometimes insulin injections are not enough to control diabetes. Eventually, a lack of insulin and uncontrolled high glucose levels can cause damage throughout your body.

Kidney disease is one of the most severe complications of Type 1 diabetes. Most people who are eligible for a pancreas transplant also have kidney failure. A pancreas transplant is often performed at the same time as a kidney transplant.

With a healthy pancreas from a transplant, a person with diabetes can begin to produce insulin (insulin independence).

Why is a pancreatic transplant done?

Pancreas transplantation is the only treatment that’s close to a cure for Type 1 diabetes. The surgery can help you live a longer, fuller life. A transplant can end the need for:

• Daily monitoring of blood glucose.
• Insulin injections.
• Food restrictions.
• Risk of diabetes complications.

What happens before pancreas transplantation?

If your healthcare provider thinks you might be a candidate for a pancreas transplant, you will need:

• Blood work and urine tests to make sure you’re healthy enough for surgery.
• History and physical exam.
• Immunological study, which helps the transplant team match you with a compatible donor.
• Imaging tests (for example, ultrasound, MRI) to make sure you’re healthy enough and to help plan surgery.
• Psychological evaluation to make sure you understand the surgery and its risks.

If the transplant team believes you’re a candidate, they’ll place you on a national waiting list for a pancreas. Many people are on the waiting list for months or even years before a matching pancreas is available.

What should I do while I wait for a pancreas transplant?

Your healthcare team will coach you on ways to stay healthy while you wait for surgery, such as:

• Attending all of your medical appointments.
• Avoiding smoking.
• Exercising regularly if you’re healthy enough.
• Limiting alcohol.
• Reporting any changes in your health to the transplant team.
• Taking medications exactly as prescribed.

Surgery should happen as soon as possible after a matching pancreas becomes available. Other ways you can prepare for surgery include:

• Making sure the transplant team can contact you at all times.
• Packing a bag for the hospital so you’re ready to go on short notice.
• Telling friends, family and your employer about your situation so they can plan to act quickly to support you.

What happens during pancreas transplantation?

A pancreas transplant takes about three to five hours (almost twice as long for a combined kidney and pancreas transplant).

You’ll be asleep under general anesthesia the entire time, so you won’t feel anything. The surgeon will:

• Make incisions (cuts) along your belly from below your breastbone to below your belly button. Sometimes the surgeon makes additional incisions in your groin, between your abdomen and thigh.
• Place the donated pancreas along the right side of your abdomen.
• Attach it to nearby blood vessels and your small intestine (part of your digestive system).
• Leave your original pancreas in place so it can still produce digestive juices.
• Close the incisions with stitches.

What happens after a pancreatic transplant?

After a successful operation, the transplanted pancreas will start making insulin right away.

Your provider will move you to a special unit in the hospital and monitor you for:

• Any medical issues.
• Complications from surgery.
• Organ rejection.
• Recovery from anesthesia.

Various machines and wires will give your body:

• Fluids and nutrients.
• Oxygen.
• Pain killers.

Your provider will also attach you to tubes that drain urine from your body. Other tubes will remove blood and fluid from the area of surgery.

If you don’t have any complications, your provider will eventually move you to a transplant recovery room. The average hospital stay after pancreas transplantation is two to three weeks.

What are the risks or complications of pancreas transplantation?

Pancreas transplantation is a complex procedure with risks and possible complications, including:

• Blood clots.
• Infection.
• Organ rejection, when your body tries to attack the foreign object.
• Pancreatitis, inflammation or swelling of the pancreas.

When can I go back to activities after a pancreas transplant?

Full recovery from a pancreas transplant takes about six months. Typically, people:

• Get the stitches out after about three weeks.
• Have frequent follow-up appointments and tests for several months to ensure the surgery was successful.
• Start gentle exercise and lift only light items after six weeks.
• Take a few months off work.

Your healthcare team will give you individual instructions.

What’s the outlook for a person who’s had a pancreas transplant?

If there are no complications, the outlook after pancreas transplantation is usually good. People can live years or even decades after the surgery.

About half of new pancreases still work well after five years. If a transplanted pancreas stops working, a surgeon can remove and replace it.

What medications will I need after a pancreas transplant?

You will have to take medications called immunosuppressants for the rest of your life after a transplant. They prevent your body from attacking the new organ (called rejection). These drugs can have serious side effects, but you shouldn’t stop taking them without talking to a healthcare provider.

Will I still need insulin after a pancreas transplant?

Many people who’ve had a pancreas transplant don’t need insulin anymore, but some do. In either case, episodes of low blood glucose are easier to control after pancreas transplantation.

When should I see my healthcare provider after pancreas transplantation?

Your transplant team will give you specific instructions about follow-up care. But you should seek immediate medical attention if you experience any signs of infection or organ rejection:

• Aches, including headaches.
• Chills.
• Dizziness.
• Fever higher than 100 degrees Fahrenheit (37 degrees Celsius).
• Less pee than normal.
• Nausea or vomiting.
• Pain or tenderness near your pancreas.
• Swelling or sudden weight gain.

A note from Cleveland Clinic

A pancreas transplant replaces a diseased pancreas with an organ from a deceased donor. It’s the only treatment close to a cure for Type I diabetes. Transplantation is a complex procedure with risks and potential complications. But it can help you live a longer, fuller life without insulin injections, diabetes complications and dietary restrictions.