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Pancreas Transplant Evaluation
A combined kidney and pancreas transplant is offered to people that have ESRD and Type 1 diabetes or those who are rapidly approaching ESRD and Type 1 diabetes, called pre-emptive transplant. A pancreas after kidney transplant is offered to those who have Type 1 diabetes and a prior kidney transplant. The Hume-Lee Transplant Center will perform a comprehensive evaluation to determine your transplant candidacy. Our team includes:
- Transplant Coordinator: This nurse will discuss transplantation and answer any questions you may have. Your coordinator will be your contact until you have your transplant.
- Transplant Nephrologist: The doctor who will follow you before and after your transplant. The doctor will complete a physical exam and discuss with you what tests are needed for you to have a transplant.
- Financial Coordinator: This professional will meet with you to discuss your insurance and insurance coverage.
- Social Worker/ Psychologist: These professionals meet with you to assess your readiness for a transplant.
- Transplant Surgeon: This doctor will perform your transplant surgery.
At the time of your initial appointment you will meet many of the team members. You will be given a large amount of information that day and we recommend that you bring a family member or friend with you. The initial appointment may last several hours.
Required Tests:
All individuals must have the following tests:
- HLA and blood typing to match a kidney to you
- Laboratory tests for infectious diseases, such as HIV, Hepatitis B, Hepatitis C
- Chest x-ray and EKG (Electrocardiogram) to be performed at our hospital.
- Dental clearance
- Tuberculosis skin test (PPD)
- Women must have a pap smear and baseline mammogram
Additional Tests:
Additional tests may be required after the initial evaluation, depending upon your medical history. Additional tests and images may include:
- Ultrasound of your gallbladder may be needed to check for gallstones
- Voiding cystourethrogram (VCUG) may be needed to see if your bladder empties normally
- Heart testing such as echocardiogram, stress thallium test or cardiac catheterization if there is a history of heart disease, any heart related illnesses, if there is a history of diabetes or you are over age 50
- Colonoscopy to check for cancer
Once you have completed the medical evaluation and are found to be an acceptable candidate for transplant, your information is sent to your insurance company for approval. Once we have obtained financial clearance, your name will be placed on the waiting list. Your transplant coordinator will notify you and your dialysis center or physicians.
Islet cell transplantation evaluation
An islet cell transplant may be considered for those patients who have had Type 1 diabetes for more than 5 years and meet the following criteria:
- Be between the ages of 18 and 65
- Be unable to control their blood sugar even with intensive therapy
- Be unable to adequately sense the onset of hypoglycemia (low blood sugar)
- Have had at least one hypoglycemic reaction in the past 1.6 years that cannot be otherwise explained and required medical attention
- Have diabetes complications-such as blurred vision or kidney, nerve, or blood vessel problems--despite efforts to control blood sugar
The Hume-Lee Transplant Center will perform a comprehensive evaluation to determine your transplant candidacy. Our team includes:
- Transplant Coordinator: This nurse will discuss transplantation and answer any questions you may have. Your coordinator will be your contact until you have your transplant.
- Transplant Nephrologist/Endocrinologist: The doctor who will follow you before and after your transplant. The doctor will complete a physical exam and discuss with you what tests are needed for you to have a transplant.
- Financial Coordinator: This professional will meet with you to discuss your insurance and insurance coverage.
- Social Worker/ Psychologist: These professionals meet with you to assess your readiness for a transplant.
- Transplant Surgeon: This doctor will perform your transplant infusion.
At the time of your initial appointment you will meet many of the team members. You will be given a large amount of information that day and we recommend that you bring a family member or friend with you. The initial appointment may last several hours.
Required Tests:
All individuals must have the following tests:
- HLA and blood typing to match a kidney to you
- Laboratory tests for infectious diseases, such as HIV, Hepatitis B, Hepatitis C
- Chest x-ray and EKG (Electrocardiogram) to be performed at our hospital.
- Dental clearance
- Tuberculosis skin test (PPD)
- Women must have a pap smear and baseline mammogram
Additional Tests:
Additional tests may be required after the initial evaluation, depending upon your medical history. Additional tests and images may include:
- Ultrasound of your gallbladder may be needed to check for gallstones
- Voiding cystourethrogram (VCUG) may be needed to see if your bladder empties normally
- Heart testing such as echocardiogram, stress thallium test or cardiac catheterization if there is a history of heart disease, any heart related illnesses, if there is a history of diabetes or you are over age 50
- Colonoscopy to check for cancer
Once you have completed the medical evaluation and are found to be an acceptable candidate for transplant, your information is sent to your insurance company for approval. Once we have obtained financial clearance, your name will be placed on the waiting list. Your transplant coordinator will notify you and your dialysis center or endocrinologist.
What Happens When You Are "Listed" With UNOS
At this point you have been found to be an acceptable candidate for any type of pancreas transplant; your name is placed on the national waiting list for a deceased donor combined kidney and pancreas or pancreas transplant. Unfortunately, there are more people waiting for transplants than there are organs available to be transplanted. (link to unos.org)
A frequently asked question is "How long will I wait for a pancreas"? Unfortunately, we cannot determine that exactly. Currently, the United Network for Organ Sharing (UNOS) designates how deceased organs are distributed. These waiting times vary from patient to patient due to individual medical conditions, genetic characteristics and sensitivity of the patient.
Once you are on the transplant list, you will need to be seen yearly to update your tests and insure you remain healthy for a pancreas transplant.
Note: Your transplant coordinator will send a letter notifying you, your dialysis center, and your physicianst when you have been listed.
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