You will find relevant information about pancreas transplantation on this page. This includes the answers to questions you may have and points your transplant team wish you to know. This includes the risks and benefits of pancreas transplantation and alternative treatments to pancreas transplantation.
Click on the titles below for more information about your pancreas transplant.
You can find more in-depth information in the Pancreas Information Booklet (Version 1.1 October 2018).
What is a pancreas transplant?
A pancreas transplant is a major surgical procedure to place a healthy pancreas from a deceased donor into a patient whose pancreas no longer functions.
What does the pancreas do?
Your pancreas is located behind the lower part of your stomach (see figure). The main function of the pancreas is to make insulin, a hormone that regulates the absorption of sugar (glucose) into your cells.
If your pancreas doesn’t make enough insulin or your body is unable to use the level of insulin made by your pancreas, blood sugar levels can rise to unhealthy levels, resulting in diabetes.
Why would someone need a pancreas transplant?
People with type 1 diabetes do not have enough insulin being made by their pancreas, resulting in high blood sugar levels. The high blood sugar affects blood vessels and causes progressive damage to vital organs including:
This results in various damages which you may have been advised about or are currently being treated for such as kidney disease, heart attack, retinopathy, or poor sensation in your feet.
The transplanted pancreas should start to produce insulin, leading to controlled blood sugar levels, and may relieve some of the symptoms associated with diabetes.
Types of Pancreas Transplant
There are different types of pancreas transplant and your transplant team will discuss these with you.
A pancreas transplant can also be combined with a kidney transplant. This is done simultaneously where the procedure is known as a simultaneous pancreas kidney transplant (SPK). This procedure may be suitable for patients who have diabetes and have progressive renal failure. The kidney and pancreas are received from the same donor in one operation.
A pancreas transplant may be considered for patients who have already had a kidney transplant that has good function but would benefit from normal blood sugar control with insulin. This is procedure is known as pancreas after kidney or PAK.
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Who can have a pancreas transplant?
There are a number of factors which need to be considered to determine whether you are a suitable candidate for a pancreas transplant.
Pancreas Transplant for Diabetics
Pancreas transplantation is usually reserved for treatment for type 1 diabetes where the pancreas does not make enough insulin, leading to high blood sugar. The transplanted pancreas should start to make insulin, lowering blood sugar levels and relieving any diabetes symptoms.
Pancreas transplants may also be offered to treat type 2 diabetes depending on your Body Mass Index (BMI) and blood sugar control.
Who is not suitable for a pancreas transplant?
A pancreas transplant is not the standard treatment for all patients with diabetes and not everyone is suitable for one.
The procedure is reserved for people with diabetes who are considered to have developed or be at risk of developing complicatiosn due to the diabetes.
As with all major surgical procedures, there are risks and for some people this may outweigh the benefits. This may mean you are not a suitable candidate for a pancreas transplant. There are alternative options which your transplant team will discuss with you.
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What are the risks?
A pancreas transplant is a major surgical procedure which carries a number of risks. Complications may develop during or anytime after the procedure.
Here you will find an overview of some of the complications that may arise. A summary table of the risks associated with pancreas transplant can be found at the bottom of this page. If you have any questions about the risks associated with pancreas transplant, your transplant team will be able to answer them.
Bleeding is more common in pancreas transplantation as a number of medications and infusions are given after the operation to keep blood thin to prevent thrombosis (clotting) of the pancreas graft.
Approximately 10% of patients have some bleeding after transplantation. If this occurs, blood transfusions or a return to the operating theatre may be required.
Thrombosis or Blood Clot
There is a risk of blood clot or thrombosis forming in the blood vessels of the transplant and can occur in 10% of patients.
Thrombosis is most likely to occur during the first week afer transplant and may result in the organ being removed. You will be monitored closely for signs of thrombosis while you are in hospital and when you return home.
Pancreatitis is inflammation of the pancreas. A degree of pancreatitis is inevitable. This may be due to damage to the pancreas during the process of removal from the donor, storage in ice during transportation and re-warming with your blood.
For the majority of transplants, the symptoms of pancreatitis resolve spontaneously within a few days. If your graft pancreatitis is not getting better on its own, you may need to have further surgery to wash out any fluid collections, or you may have tubes placed in your abdomen to drain these fluids collection.
Whilst the majority of pancreatitis improve on its own, approximately 10% of patients may need the transplanted pancreas to be removed.
Approximately one out of every five people who have a pancreas transplant will need to go back to the operating theatre for a further procedure to deal with any of the above complications should they occur.
A pancreas transplant has similar general risks as those as other types of major abdominal surgery. Other risks include wound infection, infection inside the abdomen, cardiac (heart) complications, deep vein thrombosis (blood clots in the legs) and pulmonary embolism (blood clots which move to the lungs).
Summary Table of Risks Associated with Pancreas Transplant
|Bleeding||10 patients in 100|
|Thrombosis (Blood clot)||10 patients in 100|
|Pancreatitis||Between 5 and 10 patients in 100|
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What are the benefits?
Having a successful pancreas transplant will reduce the on-going damage caused by high levels of blood sugar and over a period of years will help improve some of the reversible effects of diabetes.
As a result, you are likely to live longer and have less chances of further heart related problems or strokes that may affect your lifespan. Your kidney transplant is likely to work much longer when combined with a pancreas transplant in people with diabetes.
On a day-to-day basis, a successful pancreas transplant will offer you the opportunity to be completely free of insulin treatment and normal glucose control with a healthy mixed diet.
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There are alternatives to pancreas transplantation which your transplant team will discuss with you.
If you are a type 1 diabetic without kidney failure and have frequent hospital admissions due to impaired awareness of hypoglycaemia then you could be considered for islet cell transplant. You can find more information about islet transplantation by going to the Islet Transplant page.
Simultaneous Islet Kidney Transplant (SIK)
If you have been considered for simultaneous pancreas kidney transplant but either you or we consider the risks of surgery to be too great, simultaneous islet kidney transplant may be a possibility for you.
Kidney Transplantation from Living Donor
If you have diabetes and renal failure you can also consider kidney transplant alone from a living donor. You can find more information on live kidney transplantation by going to our Live Kidney Donation page.
Kidney Transplantation from Deceased Donor
Alternatively, you could opt to have a kidney transplantation from a deceased donor, either due to your personal preference, or upon advice from a the transplant team if the risks relating to the operation appear to be high (after thorough assessment). Head over to our Kidney Transplant page where you will find more information about kidney transplants.
If your new kidney has good function but you would benefit from normal blood sugar control without insulin, you may be considered for pancreas transplant.