Pancreas Transplantation

Pancreas transplantation is a type of surgery in which you receive a healthy donor pancreas.

A pancreas transplant is an option for some people with type 1 diabetes. Type 1 diabetes is an autoimmune disease in which the pancreas stops producing the hormone insulin. The usual treatment for type 1 diabetes involves daily injections of insulin.

During a pancreas transplant, you’ll receive a healthy pancreas from a donor who has died. If you have kidney failure from your diabetes, your surgeon may also do a kidney transplant at the same time. The kidney transplant may be done earlier or even after the pancreas transplant.

What’s different about a pancreas transplant compared with a heart transplant, for instance, is that your own pancreas remains in your body. During the surgery, the surgeon will connect the new pancreas to your bladder or to the intestines so its digestive juices can drain. After a successful transplant, you’ll no longer need to take insulin. Instead, the new pancreas will create insulin for you. You can eat a regular diet, too. You’ll have few or no episodes of low blood sugar or insulin shock and your risk for kidney damage will go down.

Who is a candidate for the transplant?

Candidates for pancreas transplantation must have type 1 diabetes along with nerve damage, eye problems, or another complication of the disease. Usually, health providers consider a transplant for someone whose diabetes is out of control despite medical intervention. People with type 2 diabetes still produce some insulin, so a new pancreas would not help them. A pancreas transplant also works best on people without heart or blood vessel disease. If you're chosen for a transplant, you may be asked to stop smoking or lose weight before the surgery. 

What are the risks?

The procedure’s risks are infection and rejection. Rejection happens when the body’s immune system mistakes the new organ as a “foreign” invader and attacks it. To reduce the chances of rejection, doctors try to match the blood and tissue type of the organ donor to the person getting the transplant.

After the transplant, doctors prescribe special drugs that suppress the immune system, such as azathioprine and cyclosporine, to help prevent rejection of the new pancreas. However, these drugs make it more likely for transplant patients to pick up infections like colds and the flu.  Over time, the drugs may also increase the risk for certain cancers. Because of the higher risk for skin cancer, for example, it’s important to cover up and wear sunscreen. If you get a pancreas transplant, you must take special medications as long as you have the transplanted organ in your body. It’s also crucial to keep all your doctor appointments.

Is there a waiting list?

Currently, more people are in need of a healthy pancreas than can be provided for with donors. The wait for a pancreas can be quite long – on average, 300 to 400 days. When a donor pancreas is not available, a partial pancreas from a living relative can be donated. Surgeons may plan to do a pancreas transplant at the same time as a kidney transplant, to help control blood glucose levels and reduce damage to the new kidney. The chance of rejection is less if doctors ensure that the living donor’s blood proteins are compatible with those of the patient. 

What is the outlook after a pancreas transplant?

The long-term outlook for people who receive a pancreas transplant is quite good. A recent report in the Review of Diabetic Studies found that the five-year survival rate for pancreas transplant patients during the past 25 years is greater than 83 percent. People who receive simultaneous kidney-pancreas transplants also tend to have less chance of rejection