Pancreas is an organ that lies behind the lower part of your stomach. The main function of pancreas is to make insulin, a hormone that regulates the absorption of glucose into the cells. If pancreas doesn’t make enough insulin, blood sugar levels can rise to unhealthy levels, resulting in Type 1 diabetes. Type 2 diabetes occurs when the body becomes resistant to insulin or unable to use it properly, rather than due to a problem with insulin production in the pancreas.
The aim of a pancreatic transplant is to restore normal blood glucose levels in the body through the transplanted pancreas.
During pancreas transplant, a healthy pancreas from a deceased donor is surgically placed into a person whose pancreas no longer functions properly. Most pancreas transplants are done to treat type 1 diabetes and indeed, it offers a potential cure for this condition. However, this option of pancreas transplant is not suitable for every patient. This surgical procedure is usually reserved for those with serious complications of diabetes because the side effects of a pancreas transplant can be substantial. Pancreas transplants may also treat type 2 diabetes in some cases. This procedure is usually done alongside a kidney transplant in people with diabetic nephropathy.
Why it’s done?
Before your treating doctor suggests you a pancreas transplant, he/she will closely evaluate benefit vs. risk of this procedure in your case. It can bring back the normal insulin production and improve blood sugar control in people with diabetes, but it’s not a typical treatment protocol. After a pancreas transplant, the person is given anti-rejection medications that often have serious side effects.
Your treating doctor along with the transplant surgeons may consider a pancreas for you, if you are found with any of the following:
- Uncontrolled type 1 diabetes
- Frequent insulin reactions (Hypoglycemic unawareness)
- Constantly poor blood sugar control
- Severe kidney damage
- Type 2 diabetes accompanied with both low insulin resistance and production
A pancreas transplant usually isn’t a treatment option for people with type 2 diabetes because type 2 diabetes occurs when the body becomes resistant to insulin or unable to use it properly, rather than due to a problem with insulin production in the pancreas. But for some people with type 2 diabetes, who have both low insulin resistance and low insulin production, pancreas transplant may be a suitable treatment option.
There are quite a few different types of pancreas transplants, including:
1. Pancreas transplant alone- People with diabetes and early or no kidney disease may be suitable for a pancreas transplant alone (solitary pancreas transplant). In this surgery, a healthy pancreas is placed into a recipient whose pancreas is no longer functioning properly.
2. Combined kidney-pancreas transplant- Surgeons often may perform combined (simultaneous) kidney-pancreas transplants for people with diabetes, who have or are at risk of kidney failure. Most pancreas transplants are done simultaneously with a kidney transplant. This helps in giving a healthy kidney and pancreas that are unlikely to contribute to diabetes-related kidney damage in the future to the patient.
3. Pancreas-after-kidney transplant –Patients who are waiting for a long time for both a donor kidney and a donor pancreas to become available, a kidney transplant may be recommended first, if a living- or deceased-donor kidney becomes available. After recovering from a kidney transplant surgery, patient undergoes a pancreas transplant once a donor pancreas becomes available.
4. Pancreatic islet cell transplant- During this procedure, insulin-producing cells, aka islet cells that are taken from a deceased donor’s pancreas are injected into a vein that transports blood to the liver. The patient may need more than one injection of transplanted islet cells. In people with serious, advanced complications from type 1 diabetes, this type of transplantation is being evaluated. Sadly, this modality is not yet available in India.
Risks & Complications of the procedure
No transplant is without risk. Similarly, pancreas transplant surgery also carries a risk of significant complications, including:
- Blood clots
- Bleeding
- Infection
- Urinary complications, including leaking or urinary tract infections
- Failure of the donated pancreas
- Rejection of the donated pancreas
- Anti-rejection medication side effects
After a pancreas transplant, to help prevent your body from rejecting the donor pancreas, one has to take anti-rejection medications for the rest of their life. This can cause many side effects, including:
- Bone thinning (osteoporosis)
- High cholesterol
- High blood pressure
- Nausea, diarrhoea or vomiting
- Sensitivity to sunlight
Other side effects may include:
- Puffiness
- Weight gain
- Swollen gums
- Acne
- Excessive hair growth or loss
Anti-rejection drugs work by suppressing your immune system. These drugs also make it harder for your body to defend itself against infection and disease.
Let your treating doctor and your transplant surgeon together decide what’s best for you.
