Transplant - pancreas

Alternative names
Pancreas transplant

Definition
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

The healthy pancreas is obtained from a donor who has suffered brain-death, but remains on life-support. Numerous criteria must be met to assess the donor’s suitability.

In additon 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 may be done at the same time as a kidney transplant in diabetic patients with kidney disease.

Indications

A pancreas transplant may be recommended for people with pancreatic disease, especially if they have Diabetes - Type 1.

Pancreas transplant surgery is not recommended for patients who have:

Risks
The risks for any anesthesia are:

     
  • Heart attack  
  • Reactions to medications  
  • Problems breathing

The risks for any surgery are:

     
  • Bleeding  
  • Infection  
  • Scar formation

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.

Expectations after surgery
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. Having children after a transplant is possible.

The major problems with all organ transplants are:

     
  • Finding a donor  
  • Preventing rejection  
  • Long-term immunosuppression

Convalescence
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.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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