Transplanting the pancreas
Solid organ pancreas transplantation is a surgical procedure that places a healthy pancreas from another person into your body. This new pancreas performs all the work that your diseased pancreas is not able to do.
In pancreatic islet cell transplantation, islet cells are taken from one or more pancreases and transferred into another person. Once implanted, the new islet cells will begin to make and release insulin.
A successful transplant can return you to a state of good health. The pancreas you will receive is from someone who has died and donated their pancreas (deceased pancreas). This may be in combination with a kidney transplant or after a kidney transplant.
Whichever type of pancreas transplant you and your transplant team decide on, the ultimate goal is to improve your quality of life and become insulin-independent.
How it works
Combined kidney-and-pancreas transplant
For combined kidney-and-pancreas transplantation, a surgeon places the new kidney and pancreas inside your body in your lower abdomen. The surgeon connects the arteries and veins of the new kidney and pancreas to your own blood vessels. Your blood flows through the new kidney and pancreas and makes urine and insulin, just like your own kidneys and pancreas did when they were healthy. The urine flows into the bladder through the ureter of the kidney, which is surgically attached to the bladder.
The new kidney may start working right away or may take up to a few weeks to make urine. Your own kidneys are usually left where they are, unless they are causing infection or high blood pressure. The pancreas produces insulin and other digestive enzymes, which drain through the pancreatic duct into the duodenum (part of your intestines).
The new pancreas is also attached to part of your duodenum, which allows these enzymes to drain. Your own diseased pancreas is not removed during the operation. The surgery takes six to eight hours, and the hospital stay is approximately seven to 10 days.
Pancreas transplant, after a kidney transplant, is done at a separate time. Usually a pancreas transplant is done after a living-donor kidney transplant and is for patients who have a living-donor kidney and do not want to wait for a deceased-donor combination kidney-and-pancreas transplant.
The pancreas is placed in your lower abdomen, and the surgeon connects the artery and vein of the new pancreas to your own blood vessels. The pancreas is also attached to part of your duodenum, which allows drainage of enzymes that assist with digestion. Once again, your own diseased pancreas is not removed during the surgery. The surgical procedure takes two to four hours to complete, and the hospital stay is approximately seven to 10 days.
Pancreatic islet cell transplantation
For pancreatic islet cell transplantation, a surgeon uses an ultrasound to guide the placement of a small catheter (plastic tube) through the upper abdomen and into the liver. The islet cells are infused through the catheter into the liver.
It takes some time for the cells to attach to new blood vessels and begin releasing insulin. A second infusion may be needed for you to receive enough islet cells to become insulin-independent. The transplant procedure takes less than an hour to complete, and the hospital stay is approximately seven to 10 days.
Source of the new pancreas
You may receive a pancreas only from a person who has recently died because people cannot live without a pancreas. Unfortunately, there are more people waiting for transplants than there are organs available to be transplanted.
The United Network for Organ Sharing is the national organization that manages the allocation or distribution of organs. The waiting list has more than 120,000 people in need of all organ transplants and 2,000 are waiting for a combined kidney-and-pancreas transplant in the United States. There are close to 1,200 people waiting for a pancreas alone.*
Waiting times vary from patient to patient due to individual medical conditions, genetic characteristics and sensitivity of the patient. This is often why more and more people are choosing to have a living donor kidney transplant, followed by a deceased donor pancreas transplant.
*Data taken from OPTN/SRTR