The Pre-Transplant Evaluation Process

What preparation is required for a pancreas transplant?

Before patients become transplant candidates they must:

1. Attend a teaching session presented by a transplant coordinator. This session will address the questions and concerns of the patient and family.
2. Attend a pre-transplant interview with the transplant team, who will review all issues and answer questions.
3. A cystogram may be needed, which is a study of bladder function. To conduct this test, a catheter is placed temporarily into the bladder. To be determined by the team.
4. Undergo laboratory testing, including tissue-typing and HIV testing.
5. Complete a simple heart test called a Dobutamine Stress echocardiogram, which takes a couple of hours, is performed on an outpatient basis, and helps the transplant team assess the potential risk-level of the proposed surgery.

Following the interview with the team, additional tests may be requested. Many of the tests listed above can be performed by your nephrologist.

Are the recipient’s pancreas and kidneys removed?

The recipient’s pancreas is not removed, nor – as a rule – are the kidneys. However, a transplant surgeon will evaluate the option of kidney removal. The most common reason for removal of the original kidneys is frequent urinary infections.

Where do the donor organs come from?

Donor organs are obtained from stable, heart-beating individuals who have been declared “brain dead” due to traumatic events. Brain death, or the determination of death by neurological criteria, is the irreversible cessation of all functions of the brain. In all cases, consent for organ donation is obtained from the donor’s family or next of kin. Artificial support is used to keep the donor’s other organs functioning until donation occurs.

A person selecting this type of transplant must wait until a suitable donor becomes available. Then, this donor undergoes extensive testing to document that the removed organs are functioning normally and are free of disease. Donor organs are matched to recipients based on blood type, tissue type, medical need, and length of time on the waiting list. Once a pancreas is removed from a stable donor, the team has approximately 24 hours to safely perform the transplant. During this time, laboratory testing determines compatibility between the donor and potential recipient.

How long is the wait for a donor organ?

Once approved for transplant, the candidate is placed on University Hospital’s waiting list. The average waiting time for a pancreas transplant in the United States is six to 12 months, but it is hard to estimate how long the candidate will wait for a suitable donor organ. People on the waiting list continue to perform normal, daily activities. Some may be asked to lose weight or quit smoking.

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