Daily injections of insulin is a daunting task for many individuals with type 1 diabetes. Most people with type 1 diabetes would like to undergo a pancreas transplant if given the opportunity. This surgical procedure involves placing a healthy pancreas from a deceased donor into a person with a malfunctioning pancreas.
It is important to note that by far, almost all pancreas transplants are done for type 1 diabetics. In type 2 diabetes, the pancreas in most people is functioning to a variable degree and continues to make insulin. Hence, for individuals with type 2 diabetes a pancreas transplant is not a viable option.
Pancreas transplants started about 15 years ago in the U.S. Since then the implantation technology has steadily improved. Undergoing a pancreas transplant involves several implication. It is a major surgical procedure with serious complications. In addition, the patient needs close post surgery monitoring for life and has to take potent medications to prevent rejection. Hence, a pancreas transplant is often reserved for patients who have critical situations. In most cases, a pancreas transplant is combined with a kidney transplant.
Pancreas Transplant Scenarios
A pancreas transplant may be a consideration in the following scenarios:
- Individual with Type 1 diabetes who is unable to control the blood sugars with available medications.
- There is a need for frequent and higher doses of insulin
- Blood sugars remain out of control despite intense insulin treatment
- The individual with diabetes also has irreversible kidney damage complications of pancreas transplantation
Potential Post-Surgery Complications
Once the surgery is done, complications that may arise include:
- Blood clots
- Infection- especially urinary tract
- High levels of blood sugar
- Failure of the donated pancreas to work
- Rejection of the donated pancreas
In addition, the medications used to prevent rejection have a whole host of potent adverse effects.
Pancreas transplantation is only done at certain medical centers. Furthermore, not all procedures have the same success. Selection of a reputable center and surgical team is a critical factor to success. One should compare the statistics from the transplant registry and talk to patients who have carried out transplants in the past to learn more about the procedure and its underlying challenges. Once you have selected the center, you will be assessed for your physical fitness to withstand surgery and to determine if you will also need a kidney transplant at the same time. Your name will be placed on the transplant list and the waiting time varies from 4 weeks to 12 months, because of a shortage of donors. Even if a donor is found, he or she needs to match your blood and tissue type.
The surgery for a pancreas transplant requires general anesthesia and can take up to 5-6 hours if you have both the kidney and pancreas transplanted. After surgery, you may be required to stay at the hospital for 7-14 days. You will have a tight follow up schedule after discharge to ensure that the grafts are working and there are no signs of rejection. Lastly, you will need to take anti-rejection medications for life.