The Transplant Procedure

How long is the operation?

Combined pancreas/kidney transplants are usually completed within 8-10 hours.

Where are the new organs placed?

During the transplant operation, an incision is made in the center of the lower abdomen. The pancreas is placed on the right side of the abdomen and attached to the bladder or the bowel. This placement allows for fluid and enzymes that the body does not need to exit through the urine or stool. If a kidney is transplanted also, it will be placed on the left side of the abdomen through the same incision. Your transplant team will discuss the technique at the time of your evaluation.

How much time is spent in the hospital?

The average hospital stay for an uncomplicated transplant is about two weeks.

What are the advantages of a pancreas transplant?

Besides freeing the recipient from insulin injections, a successful pancreas transplant can sometimes reverse the complications of diabetes. For example, there may be improvements in the areas of diabetic numbness in the feet, and slow the advancement of retinopathyif these conditions are not too advanced.

Are there any disadvantages?

Other than the risks of the operation, the main risks of any transplant procedure are associated with the long-term use of medications. These medications must be taken daily for the rest of the transplant’s life, because the body can reject a transplanted organ at any time. There may be undesirable side effects from these medications. There may also be special considerations or disadvantages unique to individual patients; these will be discussed with the transplant team.

What happens after surgery?

For 24 to 48 hours after surgery, transplant recipients are kept under observation in the Intensive Care Unit (ICU). Once stabilized, they are moved to regular rooms on the Transplant Unit.

What happens after discharge?

To a great degree, transplant recipients determine the success of their transplants. For the rest of the transplant's llife, they must take daily medications to help prevent organ rejection. Prior to discharge from the hospital, they must learn the names, dosages, and major side affects of their medications. They will also be given special guidelines and instructions to follow after discharge.

Are frequent blood tests required?

For the first three months after the transplant, blood must be drawn two times a week, more frequently if there are complications. The frequency of the blood work usually decreases after three months, six months, and one year. These laboratory results help the transplant team identify a rejection episode, so it is important to adhere to this testing schedule. It is very important for transplant patients to be knowledgeable and involved in their own care following surgery.

Who pays for the transplant?

Currently, private medical insurance and Medicare’s End-Stage Renal Disease Program share the cost of kidney transplantation. The Veteran’s Administration or Medicaid may provide financial aid for some patients, although aid must be applied for – and eligibility must be determined – on an individual basis.

Coverage for the pancreas portion of the must be determined prior to the surgery. Private insurance companies vary in this coverage. All candidates for the combined procedure will be interviewed by the University Hospital Transplant Financial Coordinator, where financial arrangements will be discussed in greater detail.

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