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Pancreas Transplant Types

Upstate offers all three types of Pancreas Transplants.

Patients with diabetes who have severe kidney disease with less than 20 percent of function or who are on dialysis are eligible to receive a kidney and pancreas transplant at the same time from the same deceased donor. Thus, SPK cures both kidney disease and diabetes and renders you dialysis-free and insulin independent.

This is the standard of care that may provide many years of kidney and pancreas graft survival. The advantage of SPK transplantation is the need for only one surgical procedure. Patients in need of both pancreas and kidney transplants receive priority on the waiting list. Typically, wait times are less than 2 years (in contrast to the 4-6 years for a kidney transplant alone).

For patients who have undergone a successful kidney transplant but continue to suffer from progressive diabetic complications or worsening glucose control, a subsequent pancreas transplant is a viable option to become insulin-independent.

For patients who need both pancreas and kidney transplants and who have a living kidney donor, the kidney transplant is often performed first to stop or prevent the need for dialysis. This avoids waiting on the deceased donor list and results in improved long-term function of the living donor kidney. As early as 3 months after the successful living donor kidney transplant, the patient

may undergo a pancreas transplant to cure diabetes and prevent further diabetic complications. A pancreas transplant will protect the transplanted kidney from failing due to diabetes-induced renal failure (as the native kidneys did). The disadvantage of PAK is that patients require two surgical procedures. Patients who receive a PAK transplant may enjoy decades of insulin-free life with normal blood glucose control.

Candidates for a pancreas transplant alone are patients who, despite best efforts, suffer from frequent life-threatening hypoglycemic episodes, night-time hypoglycemic unawareness, extreme fluctuations in blood sugar levels or rapidly worsening diabetic complications such as retinopathy,

neuropathy and gastroparesis. Although PTA will resolve these serious diabetic complications and may be life-saving, the trade-off is the need for long-term immunosuppressive therapy with its associated side effects including worsening kidney function. Therefore, PTA is offered to diabetic patients who have normal or near-normal kidney function so as not to cause premature kidney failure.
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