At Providence, our specialized teams perform pancreas transplant surgery to improve the health of people with diabetes and related complications. Our experienced transplant surgeons are specialty trained and certified to perform pancreas and multiple-organ transplant procedures.
During a pancreas transplant, your surgeon replaces a diseased pancreas with a healthy pancreas from an organ donor. This procedure may help if you have insulin-dependent diabetes and complications such as hypoglycemic unawareness.
Among other jobs, your pancreas manages blood sugar by releasing insulin and glucagon hormones. If you have type 1 diabetes, your pancreas can’t make insulin. Pancreas transplant surgery helps manage blood sugar and eliminates the need for insulin injections, restrictive diets and frequent blood testing. Doctors sometimes advise a simultaneous pancreas-kidney transplant to treat kidney failure due to diabetes.
With a new pancreas, you’ll begin to make your own insulin. You will no longer need insulin injections, but you will need post-transplant care and medications.
To be considered for a transplant, you will complete thorough testing and evaluation by Providence transplant specialists. Our transplant team will talk to you about criteria, such as your health and medical condition, insurance, lifestyle habits, and medical, personal and practical support before and after surgery.
You must also meet these guidelines:
- Have diabetes requiring insulin with daily insulin needs less than or equal to 1 unit/kilogram.
- Body mass index less than or equal to 30 with C-peptide less than or equal to 2 ng/ml.
- BMI less than or equal to 28 with C-peptide greater than 2 ng/ml.
- Have adequate insurance to cover the transplant, medications, office visits and lab testing needs after transplant.
- Have a plan for who can be immediately available to support you following transplant. This means having friends or family who can help drive you to and from office visits, lab testing and provide home care needs. You must have a way to personally understand and manage (or have someone help you manage) the medical treatments that are needed to be a successful transplant patient.
- Kidney transplant is not a cure and requires taking medications for life, regular lab testing and doctor visits.
- No active chronic or untreatable infection, for example a chronic bone infection or large wounds.
- No severe heart disease or other severe blood vessel disease. This means not having blockages in your blood vessels that limits your physical activity or puts you at high risk for a heart attack or losing a limb. You cannot have blockages that make it difficult for the surgeon to safely perform the transplant such as seen with very hard and narrowed blood vessels. Must meet specific criteria for cardiac function.
- No severe liver or lung disease or other uncontrolled medical problems, which makes risk for surgery or complications from transplant medications too great.
- No current cancer or a cancer with high risk to reoccur. If you have had cancer, you must have an adequate period of observation after treatment to assure there is no recurrent before you may qualify for transplantation.
- No use of nicotine products.
- No active use of recreational or illicit drugs (including marijuana).
- No untreatable mental illness. If you have a mental illness, it must be well treated and you must have a treatment plan that includes routine psychology or psychiatry follow up. You must also have a good social support system. This may include a group of friends, family, co-workers or church members.
- Demonstrate medical compliance by completing and attending all dialysis sessions as prescribed, attending doctor’s visits, taking medications as prescribed, and completing the transplant evaluation as scheduled.
- Must have a primary care physician or a diabetic physician to provide care after transplant.
If our transplant team finds that you’re a good candidate for a new pancreas, we will notify you and put your name on a national waitlist. Once a matching donor organ is available, your transplant coordinator will immediately contact you to arrange transplant surgery. It’s important to be prepared, have transportation ready and have your phone with you at all times.
Your coordinator will provide important details about refraining from food or drink, managing medications, and where to check in.
Before surgery, you’ll have lab tests and pre-surgery preparations. Your care team will talk to you about what to expect and place an IV line in your arm for medications.
During your procedure, your family stays in the waiting room. We’ll keep them informed during your surgery, which takes about three hours. If you have a pancreas-kidney transplant, it may take up to six hours.
Once you wake up and recover from anesthesia, your care providers will take you back to your hospital room. Your doctor will assess and follow your condition and progress. Specialized nurses provide close care. You may stay in the hospital for three days to a week until doctors decide you’re ready to go home.
Your care team will schedule follow-up appointments with your doctor and regular lab tests for a month or two. Your transplant team will provide instructions for home care and recovery.
After surgery, you won’t need insulin or regular blood-sugar checks and special diets. Diabetes-related complications may slow or improve. You’ll require follow-up checkups, blood and imaging tests, and anti-rejection medication for several years or longer after your transplant.
As with any procedure, there are risks associated with general anesthesia and surgery in general. Potential risks of pancreas transplant surgery include:
- Adverse reactions to medicines
- Breathing problems related to general anesthesia
- Clotting in blood vessels of the new pancreas
- Development of certain cancers over time
- Pancreatitis (inflammation)
- Fluid leakage where the new organ attaches to your intestine or bladder
- Organ rejection