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.

Alternative Names

Transplant - pancreas; Transplantation - pancreas

Description

The healthy pancreas is obtained from a donor who has suffered brain-death, but remains on life-support. The donor pancreas must meet numerous criteria to make sure it is suitable.

A portion of the first part of the small intestine, called the duodenum, is transplanted along 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 placed in the right lower portion of the patient's abdomen. Blood vessels from the new pancreas are attachmented to the patient's blood vessels. The donor duodenum is attached to the patient's intestine or bladder to drain pancreatic secretions.

The surgery for a pancreas transplant alone takes about 3 hours. However, the operation is usually done at the same time as a kidney transplant in diabetic patients with kidney disease. The combined operation takes about 6 hours.

Risks

The risks for any surgery are:

• Bleeding
• Breathing problems
• Heart attack or stroke
• Infection or abscess
• Reactions to medications
• Scar formation

The risks for pancreas transplant include:

• Blood clots (deep venous thrombosis)
• Clotting (thrombosis) of the arteries or veins of the new pancreas
• Inflammation of the pancreas (pancreatitis)
• Leakage of fluid from the new pancrease where it attaches to the intestine or bladder

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 (weaken) the body's immune response . This makes the person less able to fight various infections and can cause other medical problems.