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Pancreas transplant

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Illustrations

Endocrine glands
Endocrine glands
Pancreas transplant - series
Pancreas transplant - series

Alternative Names    Return to top

Transplant - pancreas

Definition    Return to top

A pancreas transplant is surgery to implant a healthy pancreas from a donor into a patient with diabetes. Pancreas transplants give the patient a chance to become independent of insulin injections.

Description    Return to top

The healthy pancreas is obtained from a donor who has suffered brain-death, but remains on life-support. The donor pancreas must meet numerous criteria to make sure it is suitable.

In addition to insulin, the pancreas produces other secretions, such as digestive enzymes, which drain through the pancreatic duct into the duodenum. Therefore, a portion of the duodenum is removed with the donor pancreas. The healthy pancreas is transported in a cooled solution that preserves the organ for up to 20 hours.

The patient's diseased pancreas is not removed during the operation. The donor pancreas is usually inserted in the right lower portion of the patient's abdomen and attachments are made to the patient's blood vessels. The donor duodenum is attached to the patient's intestine or bladder to drain pancreatic secretions.

The operation is usually done at the same time as a kidney transplant in diabetic patients with kidney disease.

Why the Procedure is Performed    Return to top

A pancreas transplant may be recommended for people with pancreatic disease, especially if they have type 1 diabetes and poor kidney function.

Pancreas transplant surgery is not recommended for patients who have:

Solitary pancreas transplant for diabetes, without simultaneous kidney transplant, remains controversial.

Risks    Return to top

The risks for any anesthesia are:

The risks for any surgery are: The body's immune system considers the transplanted organ foreign, and fights it accordingly. Thus, to prevent rejection, organ transplant patients must take drugs (such as cyclosporine and corticosteroids) that suppress the immune response of the body. The disadvantage of these drugs is that they weaken the body's natural defense against various infections.

Outlook (Prognosis)    Return to top

The main problem, as with other transplants, is graft rejection. Immunosuppressive drugs, which weaken your body's ability to fight infections, must be taken indefinitely. Normal activities can resume as soon as you are strong enough, and after consulting with the doctor. It is possible to have children after a transplant.

The major problems with all organ transplants are:

Recovery    Return to top

It usually takes about 3 weeks to recover. Move your legs often to reduce the risk of blood clots or deep vein thrombosis. The sutures or clips are removed about two to three weeks after surgery. Resume normal activity as soon as possible, after consulting with the physician. A diet will be prescribed.

References    Return to top

Robertson RP. Pancreas and islet transplantation in type 1 diabetes.Diabetes Care. Apr 2006; 29(4): 935.

Larson-Wadd K. Pancrease and islet cell transplantation. Anesthesiol Clin North America. Dec 2004; 22(4): 663-74.

Update Date: 7/25/2007

Updated by: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.

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