BY AMBER SMITH

Patrick Nolan, 52, remembers spending his 11^th birthday at Upstate University Hospital with a new diagnosis of diabetes. The Syracuse native lived with the disease for 41 years, routinely checking his blood sugar and injecting insulin up to six times per day.

Nolan received the first pancreas transplant at Upstate since Rainer Gruessner, MD, became chief of diabetic services. Days after Nolan‘s operation, Harry Tynan, 39, of Oswego also received a pancreas transplant.

Both men had Type 1 diabetes, a disease in which the pancreas does not produce the insulin necessary for the body to process sugars. Both suffered kidney damage from diabetes, and each underwent a kidney transplant, Nolan in 2011 and Tynan in 2013. Today, pancreas transplants have further improved their lives.

“It‘s a complete change just to look forward and not have to do injections,” says Tynan. “I‘m ready to pick up the insulin pen – and now I don‘t have to.”

Nolan says “wow” whenever he checks his blood sugar. He‘s not used to such healthy numbers, and he‘s not used to the freedom of not having to check his blood sugar so frequently. “I‘m reliving my youth,” he says.

The transplanted pancreas produces insulin as soon as it‘s sewn into place. This helps the body maintain a stable level of blood sugar, avoiding dangerous fluctuations. A patient keeps his or her original pandfscreas, which continues to produce enzymes that aid in the digestion of food.

Gruessner explains that “the pancreas transplant works because it is the only way to create long-term normal glycemia, so you don‘t run into the problems of low blood sugar anymore. It stabilizes glucose metabolism.” While a pancreas transplant can reverse some types of damage caused by diabetes, it can halt the progression of kidney disease, retinopathy and circulatory problems that could lead to dialysis, blindness and amputation. And with diabetes under control, patients reduce their risk of heart attack and stroke.

Mark Laftavi, MD, surgical director of the pancreas transplant program, explains that a pancreas transplant in a young person with hard-to-control diabetes “can cure diabetes in the early stages before it damages the body.”

People with diabetes who have already developed kidney disease may be candidates for kidney and pancreas transplants done at the same time, using organs from the same donor. Or, as in the case of Nolan and Tynan, they may undergo two separate transplant operations.

“If you have a living donor, you are better to do a living donor kidney transplant and then get a pancreas,” Laftavi says. “That‘s the best option available at this time.”

 

This article appears in the fall 2016 issue of Upstate Health magazine. Click here for an interview with Nolan and Tynan about how receiving a new pancreas changed their lives, and here for an interview with Gruessner about how pancreas transplants can help diabetics.