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About Pancreas Transplant

Pre-Transplant Evaluation

Initially, patients are asked to attend a general educational meeting. All patients are encouraged to have family member(s), loved one(s) or close friend(s) accompany them to this meeting. There, patients receive information about pancreas (and kidney) transplantation from Upstate physicians and nurses. Patients will meet the staff and other patients and have the opportunity to ask questions in an informal setting.

Afterwards, patients choose a day for their medical evaluation. This day is devoted to assessing a patient’s health and suitability for transplantation. You will meet members of the transplant team to discuss your particular needs and wishes for transplantation as well as to answer any remaining questions. You will also have specialized blood tests that will determine your tissue typing which is critical for matching to potential donors. Plan on the first visit lasting several hours. Your family is encouraged to come with you.

  • The pre-transplant coordinator will meet with you and gather all of your medical information. The coordinator will guide you through the process of becoming a candidate on the pancreas or pancreas and kidney transplant list. The pre-transplant coordinator will arrange for any additional tests that may be required for you to be eligible for pancreas transplantation. Some tests are done at Upstate University Hospital, others can be arranged with your endocrinologist, nephrologist or primary care physician. These tests are to ensure that you are in the best possible health to have a safe transplant procedure.
  • The financial coordinator will meet with you to review your insurance coverage. The financial aspects of transplant care are complicated and often confusing. Our financial coordinator is there to explain and help with this process and make sure that you have the best possible medical coverage. Insurance coverage exists for most pancreas transplants but not for islet transplantation.
  • The social worker will meet with you to talk about a plan for your care following your pancreas transplant. This is to make sure that you have the support that you need to get through the transplant process and the first few weeks after the transplant.
  • The nutritionist will meet with you to review your current diet and nutritional status. The nutritionist may make dietary suggestions that will help you become as healthy as possible before and after transplantation.
  • The pharmacist will review your current medications. The pharmacist will explain any potential changes in your medications that may occur after a pancreas transplant and will help with all antirejection medications after transplantation.
  • You will meet a transplant physician who will review your medical history and perform an examination. The physician will answer any questions that you may have about transplantation, including donation and post-transplant care as well as about the development and/or progression of the secondary complications of diabetes mellitus.
  • You may also meet an endocrinologist or diabetologist if your blood sugar levels widely fluctuate or if you have frequent episodes of hypoglycemia. We work closely with our colleagues from Upstate’s Joslin Diabetes Center. Pancreas transplantation is a complimentary and not a competing option for diabetic patients. In fact, patients with stable glucose and hemoglobin A1c levels and without secondary complications of diabetes may do very well on insulin pumps or other devices.
  • Finally, you will meet with a transplant surgeon who will go over your medical history and explain the pancreas transplant procedure, including potential risks and complications.

Specifically, the surgeon will let you know that a pancreas transplant is a more difficult procedure than a kidney transplant and that the hospital stay may be prolonged if a surgical complication occurs (in about 5 to 15 percent of patients). Please note that the transplant surgeon that you meet in the clinic may not be your actual surgeon. This depends on which surgeon is on call the day of your surgery.

Over the following weeks, the transplant team meets to determine if you are sufficiently healthy to receive a pancreas transplant or if you will require further medical testing or evaluations. Since diabetic patients are prone to cardiac disease, special emphasis will be on your cardiac evaluation, which may include a study to determine any abnormalities in your coronary arteries. Once all of your testing is completed, you will be notified of being placed on the pancreas transplant list. To make sure that you remain healthy for transplantation, the transplant team will reevaluate you each year that you do not receive a pancreas transplant.