Why is pancreas transplant done?

 Normal insulin production can be restored by a successful pancreas transplant and it can also improve blood sugar control in people with diabetes. It is also important to know that the side effects of the anti-rejection medications that is needed after a pancreas transplant can often be severe.

The doctors can consider pancreas transplant for people with any of the following conditions:

• Type 1 diabetes that is incapable of being managed with standard treatment
• Recurrent insulin reactions
• Consistently poor blood sugar control
• Severe kidney damage
• Type 2 diabetes that is related to both low insulin resistance and low insulin production

Pancreas transplant generally is not considered a treatment option for people with type 2 diabetes. This is because type 2 diabetes occurs when the body becomes resistant to insulin or is not able to use it properly, instead of there being an issue with insulin production in the pancreas which the transplant typically addresses.

 However, for some people with type 2 diabetes who suffer from both low insulin resistance and low insulin production, pancreas transplant can be recommended as a treatment option by the doctor.

 

What are the types of pancreas transplant?

 The types of pancreas transplant procedure include the following:

• Combined kidney-pancreas transplant - it is the transplant in which the pancreas and kidney are transplanted during the same operation
• "Pancreas after kidney" transplant - it is the transplant in which the pancreas is transplanted after a kidney transplant
• Pancreas transplant alone - it is the transplant in which only the pancreas is transplanted and is intended for patients with functioning kidneys
• Pancreatic islet cell transplant - islets are groups of cells in the pancreas. Some of those cells, known as beta cells, help in insulin production, the hormone that helps convert blood sugar into energy. An islet transplant is still an experimental treatment and is performed only at the level of clinical trials as of now. In this procedure doctors take healthy beta cells from donors and inject them into the veins of the liver.

 

What to expect during a pancreas transplant?

 During the pancreas transplant surgery, the pancreas that is donated is transplanted into the recipient whose failed pancreas has not yet been removed. The pancreas must be transplanted into the patient who is receiving the organ within hours after its removal from the donor. A team consisting of surgeons and anaesthesiologists operate to remove the pancreas from the donor. There may be other surgical teams present at the operation to remove other organs such as the kidneys, if that is also a part of the planned procedures.

Before the procedure

 The doctors will examine the patients in the weeks leading up to the transplant. Blood tests can also be used to detect infections and to ensure that the patients' blood type is a good match for the donor's. X-rays, an echocardiogram, and other tests can be used to examine the patient's heart health as well. Prior to the operation, the doctor will instruct the patient regarding when they need to start fasting before the operation as well as which of the medications being consumed by them need to be stopped.

During the procedure

 The patients will receive general anaesthesia, so that they don’t feel any pain and are unconscious during the procedure. The surgeon will cut through the skin down through the belly. The surgeon will then attach the healthy donated pancreas to the patient’s blood vessels. A small piece of the donor’s intestine will be attached to the intestine or the bladder. The patients will also retain their own pancreas to help them digest food.

 After the procedure

 After the transplant, patients will spend a few nights in the intensive care unit. They will also stay in the hospital for a few days in the recovery room post the stay in ICU. The area around the incision on the belly might be sore or painful. The patients will also undergo regular blood tests for one or two months after the procedure to check for any complications. They will also be required to take anti-rejection medication for the rest of their lives. The patients will also require regular imaging and blood tests to monitor the new organ. The doctor may also ask the patients to stay near the transplant centre for several months after the procedure.

 

What are the risks of pancreas transplant?

Pancreas transplant surgery carries significant risks of complications, including:

·        Blood clots

·        Bleeding

·        Infection

·        Hyperglycemia or other metabolic issues

·        Urinary complications, this includes leaking, urinary tract infections

·        Failure of the donated pancreas

·        Rejection of the donated pancreas

 

Anti-rejection medication side effects

After the pancreas transplant, patients will consume medications for the rest of their lives to assist in preventing the body from rejecting the donor pancreas. The anti-rejection medications can cause different side effects, among them are:

·        Bone thinning (osteoporosis)

·        High cholesterol

·        High blood pressure

·        Nausea, vomiting or diarrhea

·        Sensitivity to sunlight

The other side effects can include the following:

·        Puffiness

·        Weight gain

·        Swollen gums

·        Acne

·        Excessive hair growth or loss

Anti-rejection medications work by suppressing the immune system. These medications also make it tougher for the body to defend itself against infection and disease.

 

Conclusion

Once the doctors decide that pancreas transplant is the treatment required, the patient must be prepared for the fact that the process will be a complicated and fraught with risks. However, if the pancreas transplant is successful, then the recipients will see a significant improvement in their quality of life. People must speak to their doctor to decide if pancreas transplant is right for them.