Pancreas Transplant

A pancreas transplant is a surgical procedure that places a healthy pancreas into a person whose own pancreas cannot function properly.

The pancreas helps with digestion and produces hormones, such as insulin, that help the body maintain optimal blood sugar levels. If the pancreas cannot produce enough insulin to regulate blood sugar, a person develops type 1 diabetes.

Some people with type 1 diabetes who cannot control their blood sugar through medication or insulin would be best treated with a pancreas transplant. If their kidneys are damaged as well, they may also need a kidney transplant. A pancreas transplant is often done in conjunction with a kidney transplant in people whose kidneys have been damaged by diabetes.

There are three main types of pancreas transplant procedures:

Pancreas transplant

If a patient needs a new pancreas, but has functioning kidneys, only the pancreas will be transplanted.

Simultaneous pancreas-kidney transplant (SPK)

Patients who need both a pancreas and a kidney may have both organs transplanted at the same time. Both of the new organs usually come from the same deceased donor.

Pancreas-after-kidney transplant (PAK)

In this procedure, the pancreas is transplanted after the kidney transplant procedure is complete. The donors typically are different people.

After you have completed the necessary medical tests and received insurance approval for a pancreas transplant, the transplant selection committee at Scripps will review the results ensure it is safe for you to undergo transplant surgery. At that time, you will be placed on the wait list for a pancreas donation.

The tests are part of the evaluation process and are required to make sure it's safe for you to receive a transplant and that you meet important pancreas transplant criteria. For example, if you were found to have heart disease during your evaluation, you may need a new medication or procedure before it would be safe for your heart to undergo transplant surgery.

The entire evaluation process may take from one to several months, depending on your condition and how quickly you can complete the necessary tests.

Several factors determine how long you will need to wait for your transplant, including:

• The type of pancreas transplant you need
• How quickly you complete the evaluation testing
• The results of your evaluation testing
• Whether you have other medical conditions that require a waiting period, such as kidney failure or cancer treatment
• Your blood type (certain blood types typically wait longer than others)
• How your immune system reacts to cells or organs from other individuals
• How long you have been on the wait list

In most cases, the new pancreas should last for the rest of your life. However, several factors may affect this time frame, including:

• Rejection of the new pancreas by your immune system
• Infection
• Reaction to a medication you are taking

Fortunately, in most cases these problems can be treated. Also, if your new pancreas fails, you may resume insulin treatment and consider another transplant.

When you first go home after your transplant, you will need to take multiple new medications. These medications lower or “suppress” your immune system, so that it will accept a pancreas from someone else. Without these medications, your immune system would reject and attack your new organ.

Immunosuppression medications have a number of side effects, including raising your risk of certain infections. Some patients cannot take traditional steroid-based drugs for immunosuppression. These patients may qualify for steroid-free immunosuppression.

Over time, your transplant physician will reduce the number of medications you take, but you will need to take some immunosuppression medications for life.

You will be in the hospital for about a week. When you go home, you will need help taking care of yourself. If you are an out-of-town patient, you will need to plan to stay locally following your transplant for as long as your physician recommends. For the first four to six weeks, you must avoid lifting anything heavier than a phone book.

Depending on your job, you may be able to resume some work activities in six to eight weeks. Some patients recover quickly, and some need more time. Your recovery also will depend on how ill you were before your transplant, what type of transplant you have and whether you have any complications after the surgery. Your pancreas transplant team can answer questions about activities during recovery.

The Scripps transplant team is composed of an established, multidisciplinary panel of surgeons, hepatologists, nephrologists, hematologists and oncologists who are nationally recognized as leaders in their field at the forefront of the latest advancements and treatment options. Your care team also includes:

• Transplant coordinators
• Financial coordinators
• Social workers
• Transplant dietitians
• Pharmacists

The team is complemented by a comprehensive medical staff specially trained to care for transplant patients, and provides the full range of services our patients need to be successful.

Your transplant care team will be your partner through the transplant process and beyond. We’ll work closely with your insurance carrier, referring primary care physician and other specialists involved in your care to ensure all your health care needs are addressed with efficiency and compassion.

Our approach to medical care ensures that all our patients receive treatment plans that are customized to their individual needs. For example, patients who cannot take traditional steroid-based drugs to prevent organ rejection following a transplant may qualify for steroid-free immunosuppression.

In order to discover new treatment options and better transplant methods, our physicians participate in a variety of research activities.

View our list of active clinical trials at Scripps Health.