Pancreas Transplant Procedure
The Upstate Transplant Program is staffed by some of the most experienced pancreas transplant surgeons and physicians in the country. The program has made transplantation for diabetic patients, and specifically pancreas and islet transplantation, a cornerstone of its overall activities and is focused on bringing this life-saving therapy to our patients.
The waiting time for pancreas transplantation varies greatly and depends on the availability of appropriate organs for transplantation. Be prepared that you may get a call in the middle of the night, on the weekend or on a holiday. Carry a cell phone or a pager at all times or provide us with a phone number of a family member, loved one or friend who can be reached at all times. Being called for a pancreas transplant is a major life event and you want to be ready when that call comes in.
Once you receive the call — providing you have no new health issues or infections that may prevent the transplant — follow the instructions of the transplant coordinator. In general, you should not eat or drink after you receive the call and you need to go to the hospital as quickly as possible. When you arrive at the hospital, you will undergo more testing and you will be prepared for surgery.
The actual transplant surgery will take 3 to 6 hours depending if it is a simultaneous pancreas and kidney transplant, pancreas after kidney or pancreas transplant alone. The transplant procedure is performed through a single midline incision in your abdomen by an experienced pancreas transplant surgeon. A pancreas transplant is a tedious procedure, but in the overwhelming number of cases, it is not life-or-death surgery. Like with a kidney transplant, the inflow and outflow vessels of the pancreas are connected to blood vessels in your lower abdomen. The secretions of the pancreas are drained via a short duodenal segment into the patient’s small bowel or, rarely, into your bladder. Upon completion of the transplant procedure, you will be transferred to the Intensive Care Unit or to a Step-Down Unit before being transferred to a regular hospital unit a couple of days later. You may expect to be hospitalized between 7 and 12 days.
Post Transplant Care
During and after the pancreas transplant procedure you will receive immunosuppressive drugs that prevent you from rejecting your transplanted organ. The medications to prevent rejection are the same for pancreas and kidney transplants. Rejection episodes right after the procedure are extremely rare.
Be aware that most rejection episodes can be successfully treated if diagnosed early and if you follow the instructions of the transplant coordinator. You will stay on your immunosuppressive drugs for as long as your transplant functions. You need to take these drugs every day at the same time, no matter where you are or what day it is. Non-compliance usually results in losing the transplanted organ.
Major surgical complications requiring re-exploration after pancreas transplantation occur in less than 10 percent of patients. The major complication is a blood clot (<5%) in the inflow or outflow vessel and usually requires removal of the transplant. Other surgical complications, such as infection, leakage, pancreatitis, or other surgical problems rarely require transplant removal. Like with kidney transplants, re-transplantation is always an option.
Post-transplant education in the hospital is provided by Upstate nurse coordinators and pharmacists who explain the new medications and clinic visit schedule. After discharge, patients are seen by transplant physicians and surgeons frequently for the first three months to care for any immediate complications and to adjust antirejection therapy. It is crucial that you remain compliant with medications and clinic visits in order to make sure your transplant functions for many years or decades.