Why is Pancreas Transplant Needed & Who is a Right Candidate for it?

About Pancreas Transplant:

Pancreas is a vital organ of the body. It is located around the stomach and intestines. The primary function of the pancreas is to produce insulin and digestive juices used in digestion of food. Insulin is extremely important as it controls the sugar levels in the body. An optimal sugar levels ensure that enough energy is stored in the body for daily use. Coming to a Pancreas Transplant, it is a procedure where a healthy pancreas is transplanted to an individual whose pancreas is no longer able to produce enough insulin in the body. The donor can either be a deceased person from whom the entire pancreas can be transplanted or a living person from whom the pancreas can be transplanted partially.[1,2]

Pancreas Transplant is believed to be a potential cure for people with type-1 or insulin-dependent diabetes mellitus. If the transplant is successful then the patient will no longer require insulin injections to maintain regular blood sugar levels in the body. It will also eliminate the requirement of strict dietary restrictions that people with type-1 diabetes need to follow.[1,2]

A Pancreas Transplant also prevents damage to other vital organs of the body like the kidneys due to uncontrolled blood sugar levels. An individual is deemed to be a candidate for Pancreas Transplant if he or she has severe diabetes with significant kidney damage or other potentially life threatening complications due to uncontrolled sugar levels. This article goes deep into the types of Pancreas Transplant, who needs it most, the risk of the procedure, and what to expect from a Pancreas Transplant.[1,2]

What Are The Different Types Of Pancreas Transplant?

There are three ways in which a Pancreas can be done. These include:

Pancreas Transplant Alone: This procedure is performed on people who only have diabetes but do not have any kidney dysfunction.[1,2]

Simultaneous Kidney and Pancreas Transplant: This is done in people with severe diabetes where the kidney function becomes impaired.[1,2]

Pancreas After Kidney Transplant: This form of transplant is done by transplanting the kidney first. Post successful transplant of the kidney the Pancreas Transplant is done to prevent any complications. The pancreas is usually taken from a deceased donor.[1,2]

Why is Pancreas Transplant Needed?

As stated, the primary function of the pancreas is to produce insulin. This is a hormone that controls the blood sugar levels in the body and helps in energy storage after eating food. If the body does not produce enough insulin then the levels of sugars go up and less energy will be stored in the body causing a variety of complications, some of which are potentially life threatening.[2]

If an individual is deemed safe to have a Pancreas transplant then it will allow the patient to have good control of the blood sugar with a normal functioning pancreas and not having to take insulin shots and other restrictions that need to be followed in people with insulin dependent diabetes mellitus. It will also prevent the patient from having other major complications adherent to type-1 diabetes mellitus.[2]

Who Is The Right Candidate For A Pancreas Transplant?

Pancreas Transplant is exclusive only for people with insulin dependent diabetes who are not able to control their blood sugars appropriately or are needle-phobic and are not able to administer insulin shots. Pancreas Transplant is done in people who:[2]

  • Have frequent syncopal spells due to uncontrolled blood sugars.
  • People who have to go to the emergency room on a frequent basis due to symptoms caused due to high blood sugar.
  • People with persistently high blood sugars.
  • People who are dependent on others for daily activities despite adequate medical therapies.
  • Kidney failure as a result of complications of diabetes.

What To Expect With A Pancreas Transplant?

For a person to get a Pancreas Transplant, in the United States the average waiting period is approximately two to three years. This data is based on National Kidney Foundation. Prior to a transplant, the recipient will have an extensive evaluation by a team of expert physicians from various departments to include nephrology, endocrinology, and surgery. Based on the patient’s history and present condition, these experts will arrive at an opinion as to whether a Pancreas Transplant is the right choice for the patient.[2]

Once a patient is deemed to be a candidate for transplant, he or she will have to undergo a series of medical tests and investigations which will take a minimum of two months. The first thing to be done is to find a donor of the same blood group as the patient. This is then followed by comparing the antibodies of the donor and the recipient called as a crossmatch test. This is useful is determining whether the match is good enough for the transplant to be carried out.[2]

The actual transplant surgery takes about 4-6 hours to complete. Postsurgery, the patient is shifted to a transplant unit and allowed to recover for approximately two weeks.[2]

What Are The Risks Of Pancreas Transplant?

The primary risk for a patient who undergoes a Pancreas Transplant is infection after surgery even though it is an inherent risk for all major surgeries. A transplant being a complex procedure the risk of infection is that much more increased. Additionally, it is quite common for swelling of the pancreas to occur for a few days after transplant, a medical condition called as pancreatitis. The swelling should resolve spontaneously for most people; however, artificial draining is required in some cases from the donor pancreas to drain out excess fluid. This is done by inserting tubes in the stomach.[2]

Blood clot is yet another common risk that a person with Pancreas Transplant may have to deal with. This can interfere with the functioning of the new pancreas. This is the reason why people undergoing pancreatic transplant are placed on blood thinners for some time. In cases of a blood clot, a reoperation is required.[2]

Rejection of the organ by the body is the most serious risk that is present with a Pancreas Transplant. The immune system of the body may identify the transplanted organ as a foreign body and start attacking it. Rejection of the transplanted organ can occur within days of the transplantation but it can also occur after weeks, months, or even years post transplantation.[2]

The primary sign of organ rejection is swelling of the stomach along with vomiting. Additionally, the patient will have fever, fatigue, swelling of the ankles, and shortness of breath. A patient with a Pancreas Transplant will be placed on immunosuppressants to prevent rejection for the rest of their lives. This medication weakens the immune system and prevents organ rejection; however, it makes the patient prone to infections from which the patient has to be careful.[2]

Hypertension, problems with sleeping, irritability, and hair loss are some of the common side effects of immune suppressing agents. There is also an increased risk of cancer in people who are on chronic immunosuppressants. Despite these side effects, experts opine that people prefer to live with these risks rather than having to inject insulin on a daily basis. Thus it can be said that Pancreas Transplant significantly increase the quality of life of people who deal with insulin dependent diabetes and are tired of poking needles all over their body just keep their blood sugars under control.[2]

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