NewYork-Presbyterian is a leader in pancreas transplantation in the northeastern United States. As part of a large academic medical center, our organ transplant teams can call upon the expertise of a wide range of healthcare providers, ensuring that you receive the most advanced, multidisciplinary care at our transplant centers.
What is a Pancreas Transplant?
What is a Pancreas Transplant?A pancreas transplant is a highly specialized transplantation procedure that involves placing a healthy donor pancreas into the patient. Pancreas transplants are typically done to treat type 1 diabetes, as they can help the body control blood sugar levels and eliminate the need for insulin injections.
In some cases, pancreas transplant can slow the progression of diabetes and reverse complications such as damage to the eyes and nerves. Under some circumstances, pancreas transplantations are also beneficial for type 2 diabetics.
Pancreas transplant options
The pancreas’ main role is to help transform food into fuel your body can use. The pancreas has two main functions: endocrine, which helps regulate blood glucose – and exocrine, which aids in digestion. The endocrine function involves the release of hormones including insulin and glucagon, which maintain blood sugar. The pancreas’ exocrine glands produce enzymes like trypsin and chymotrypsin that digest proteins, and other enzymes that digest carbohydrates and fats.
The pancreas and kidney work together to help maintain the health of each organ. Kidneys filter waste from the blood, keeping the pancreas healthy. The pancreas, meanwhile, produces insulin and maintains blood sugar to help protect the kidney from damage. In some cases, both organs need to be replaced to help treat diabetes.
- Pancreas transplantation alone. We perform this procedure in people without kidney disease who have life-threatening complications of diabetes, such as hypoglycemic unawareness.
- Pancreas-kidney transplantation. This is an option for people who also need a kidney transplant but do not have a living donor; they are placed on the deceased donor waiting list for a donor who can provide both organs. Transplanting the pancreas and kidney at the same time not only treats the diabetes, but also allows the transplanted pancreas to protect the new kidney from the damage caused by diabetes.
- Pancreas after kidney transplantation. This option is for people who have already received a kidney transplant and qualify for a pancreas transplant due to their inability to control their diabetes despite aggressive medical care.
What Conditions are Treated by a Pancreas Transplant?
Conditions TreatedA pancreas transplant typically treats type 1 diabetes, in order to provide the patient with a healthy pancreas that can produce insulin. The operation is usually reserved for people who have serious complications of type 1 diabetes, but it is also sometimes done when a patient has severe kidney damage. Under some circumstances, pancreas transplantations are also beneficial for type 2 diabetics.
You may be a candidate for pancreas transplantation if you have type 1 diabetes and have developed severe complications, such as:
- Kidney disease (nephropathy) that is end-stage and may require dialysis or a kidney transplant
- Eye problems (retinopathy)
- Nerve discomfort (neuropathy)
- Inability to sense when you have low blood glucose (“hypoglycemic unawareness”), a life-threatening condition
- Incapacitating clinical and emotional problems associated with insulin therapy
- Consistent failure of insulin treatment to manage diabetes complications
How is a Pancreas Transplant Performed?
How is a Pancreas Transplant Performed?Pancreas transplants are surgical procedures that can take up to three to six hours. Before surgeons begin the pancreas transplant, you are placed under anesthesia by an anesthesiologist or anesthetist, so you are not awake during the surgery.
The steps in a pancreas transplant procedure typically include:
- The surgeon makes an incision down your abdomen, after which the donor pancreas is placed into your lower abdomen – along with a small part of the donor’s small intestine.
- The new pancreas is connected to your blood vessels.
- The surgeon attaches the donor intestine to your small intestine. Typically, your old pancreas will stay in place and isn’t removed.
During a pancreas-kidney transplant, the surgeon connects the new kidney’s blood vessels to the nearby blood vessels in your lower abdomen.
Following the procedure, your new pancreas should begin working right away. You’ll remain in the intensive care unit for a few days, monitored by doctors and nurses who make sure you don’t develop any complications. Your healthcare team will also prescribe medications that suppress your immune system to help prevent your body from rejecting the new pancreas.
Benefits & Outcomes
Benefits & OutcomesReplacing a non-functioning organ with a healthy organ gives patients suffering from chronic diseases like diabetes and kidney disease an opportunity to live a full life. In general, patients who have had a successful pancreas transplant report the following benefits:
- Increased freedom. Patients who undergo a pancreas transplant no longer spend hours of their day controlling their blood sugar, taking insulin, or being restricted to a specialized diet.
- Decreased diabetic complications. Pancreas transplant patients see a significant reduction or an end to their diabetes-related side effects.
- Slower disease progression. Most people with nerve damage due to diabetes find that after their pancreas transplant the damage does not get worse and in some cases, the nerves begin to repair.
Transplant patients do need to adhere to a healthy diet after surgery and will be on immunosuppressant drugs to prevent organ rejection.
Risks to Consider
Risks to ConsiderAs with any medical or surgical procedure, risks and benefits should be discussed with your healthcare providers and your family. One major risk of a pancreas transplant is the possibility of your immune system rejecting and attacking the new pancreas, possibly resulting in abdominal pain, high blood sugars and fever.
Typically, transplant rejection is treated with increased use of immunosuppressant medication. If another pancreas transplant is needed, you will be able to begin insulin treatments again until the second procedure.
Other risks include blood clots developing in the blood vessels that connect to the donor pancreas, and inflammation of the pancreas (pancreatitis). There are also side effects from the immunosuppressant medications, which can lower the strength of your immune system and increase your risk of certain infections.
Despite these risks, however, the patient survival rate for pancreas transplant or pancreas-kidney transplant is around 95% at one year, and around 90% after five years.
Preparing for a Pancreas Transplant
Preparing for a Pancreas TransplantPreparing for a pancreas transplant starts well before the day of surgery, and is a process where your healthcare team will determine your best course of treatment. The average wait time for a pancreas or pancreas-kidney donation can be anywhere from one to several years. Before the procedure, you will undergo a pre-transplant evaluation, to ensure you qualify for and are healthy enough for the operation. If your doctor deems you a candidate for a pancreas transplant, preparations include:
- Medical history and physical exam. Your doctor will examine whether you have certain medical conditions that could make a pancreas transplant difficult.
- Imaging tests. Your doctor may make you undergo CTs or ultrasounds to make sure you’re healthy enough for surgery.
- Blood and urine tests that ensure you’re healthy for surgery.
- Immunological study. An immunological study will help your doctor and transplant team find a compatible donor for you.
- Discussion around the risks of surgery to make sure you understand them.
- Staying healthy. During the year or so of your wait time, you will want to adhere to a healthy lifestyle to ensure a successful surgery. That may include following a healthy diet and exercise plan, maintaining a healthy weight, or quitting smoking or alcohol.
What to Expect After a Pancreas Transplant
After a Pancreas TransplantFollowing the pancreas transplant, you will have several weeks and months of recovery, starting out with a stay in the intensive care unit immediately after surgery. Taking care of your body after a pancreas transplant is a lifelong endeavor. Your doctor may have more specific instructions tailored to you.
After a pancreas transplant, you can expect to:
- Remain in the intensive care unit post-surgery. Your care team will keep you in the ICU for several days following your transplant to monitor potential complications and provide you with fluids and painkillers. You may need tubes that drain urine, blood or fluid from your body post-surgery.
- Recover in the hospital for a week. After your stay in the ICU, your doctor will deem you stable and may move you to a transplant recovery area of the hospital. Typically, you may experience some pain or soreness around your abdomen during this time.
- Take immunosuppressant medications. Patients who receive a pancreas transplant will need to take immunosuppressants for the rest of their lives to prevent organ rejection.
- Checkups with your doctor for the next month. Once you’re home and recovering, you should adhere to frequent checkups with your care team to make sure you’re healing properly.
- Long-term healthy changes like diet, exercise and medications will contribute to the prolonged success of the transplant.
FAQs
This content has been reviewed by the following medical editors.
Receive a Pancreas Transplant at NewYork-Presbyterian
NewYork-Presbyterian is one of a few locations in the state offering pancreas transplantation. Associated with two Ivy League institutions, patients at our medical centers have access to the latest surgical and medical technology, which improves patient outcomes and helps you get back to a healthy life more quickly. Our team of specialists can discuss the treatment options available for your specific condition during your appointment.
Our pancreas transplant care team draws on the knowledge, experience, and talent of healthcare professionals from a variety of subspecialty areas, including:
- Endocrinologists
- Gastroenterologists
- Nephrologists
- Nurses
- Nutritionists
- Social Workers
- Transplant Coordinators
- Transplant Surgeons