Pancreas Transplant

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Pancreas Transplant is the process of removing an unhealthy pancreas with a healthy pancreas from a deceased donor through surgery. The donor is mostly someone whose brain is dead but still on life support. Pancreas Transplant is usually done for people with diabetics type 1 conditions.

The pancreas is an accessory organ, located behind the lower part of the stomach and it plays a role in digestion and production of insulin in the body. Insulin is a hormone that helps the absorption of glucose into the body.

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Pancreas Transplant

What is a pancreas transplant procedure?

The pancreas is a gland located in the abdomen lying between the stomach and spine. A pancreatic transplant is a surgical procedure that involves replacing a healthy pancreas from a deceased donor into a person whose pancreas no longer functions properly [1]. Can pancreas transplants cure diabetes?  Yes. When the pancreas is not making sufficient insulin, the glucose level in the blood is affected as it leads to an increase of the glucose level in the blood, resulting in type 1 diabetes. Type 1 diabetes mellitus is an autoimmune disease in which the insulin-producing Beta cells are destroyed. Therefore, a pancreas transplant is mainly done to treat type 1 diabetes mellitus and a lack of insulin production patients [2][3].  Pancreas Transplant is unlikely to be recommended for the treatment of type 2 Diabetes except if their insulin production rate is low or they have a low insulin resistance level. This is because type 2 diabetes occurs when the body becomes resistant to insulin and cannot use insulin in the body suitably. Therefore, only about 10 percent of people with type 2 diabetes require a pancreas transplant.

What are the most common types?

a) Pancreas-only Transplant This transplant involves only the transplant of a healthy pancreas to a recipient’s pancreas that is no longer functioning.                                       
Pancreas-only transplant
Picture Courtesy: Pancreas transplant
b) Combined Kidney-Pancreas Transplant. To avoid diabetes-related kidney damage, this type is done for people with diabetes in danger of kidney failure. The transplant is done simultaneously.  
Combined Kidney-Pancreas Transplant.
Pic Courtesy: Mayoclinic
                      c) Pancreas after Kidney Treatment Transplant. This is done when the donor for the pancreas is not yet found, but there is a donor for the kidney. The kidney is transplanted first while awaiting a donor for the pancreas. d) Pancreatic Islet Cells Transplant Here, the islet cells of the pancreas, which is responsible for the production of insulin, are injected into a vein taking blood into the liver.
Pancreatic Islet Cells Transplant
Picture Courtesy: Drive project
                                

Criteria for Pancreas Transplant Surgery

Before proceeding for  the surgery, consider the following factors to assess eligibility:
  • Type 1 diabetes where standard treatment is unresponsive.
  • Type 2 diabetes with low insulin resistance and production.
  • Severe kidney defect.
  • Reactions to insulin.
  • Inadequate blood sugar control.
  • Improve the quality of life

Preparation and Procedure for Pancreas Transplant Surgery

When preparing for a Pancreas Transplant, the first thing to consider is a good transplantation center which includes getting details about the type of transplantation done there and their survival rate. Anavara provides you with information on quality transplant centers across the globe. For more information, visit us at [email protected] Next, you will undergo some tests, including kidney tests, to gather as much information as possible. Then you will be placed on a waiting list, which depends on
  • Blood group
  • The time interval to get a suitable donor
Most likely, the waiting list should take close to 23 months. Before the Surgery:
  • Discuss the surgery with your surgeon, ask all the questions about the surgery you don’t understand; the risks, benefits, and how to reduce the risk that comes with the surgery.
  • Undergo more tests and examinations to ascertain your health state.
  • Sign consent forms for the surgery
  • Take your medications seriously.
In Surgery:
  • General anesthesia is given to keep you unconscious during the procedure. The anesthetist gives you medications as a gas through the mask or injects medications into a vein. 
  • Then an incision is made at the center of your lower abdomen, and then the new pancreas is placed along with a small portion of the small intestine.
  • The donor’s intestine is sutured (stitched)to either the small or bladder.
  • Your pancreas is kept in place to aid digestion.
  • If a kidney transplant is involved, the healthy kidney blood vessels are stitched to your blood vessels at the lower abdomen and its ureter connected to the bladder.
  • There is no need to remove the kidney, except there are complications arising from it.
  • The patient’s heart rate, blood pressure, and oxygen rate are regularly monitored during the surgery.
After the Procedure: The nurses will take you to the intensive care unit for close monitoring. You will be administered anti-rejection drugs to avoid denial of the donated pancreas by the immune system. In addition, you will take immunosuppression medications for the rest of your life. If you stop taking these medications, then rejection of transplanted organs occurs [4]. How Long Does a Pancreas Transplant Surgery Take? It usually takes 3- 6 hours depending on whether it is only Pancreas or Kidney transplantation alone or both simultaneously. Recovery Rate The recovery rate of Pancreas Transplant varies according to the procedure used. In addition, the complexity of the procedure determines how fast the recovery will be. Nonetheless, it takes 3-5 weeks to leave the hospital with close monitoring. After discharge, the patient must do the following to enable quick recovery.
  • Frequent visits to the hospital.
  • Follow prescribed medications strictly, which may be a lifetime.

Possible Complications of Pancreas Transplants

Complications may include:
  • Blood clotting in blood vessels
  • Excessive bleeding
  • Transplantation pancreatitis (inflammation of the transplanted pancreas).
  • Hyperglycemia-increase in glucose level in the blood
  • Urinary tract infections
  • Rejection of the new pancreas or kidney by your body.
  • Hernia
  • Nerve damage
When complications come up, do not panic. Instead, make a complaint to your surgeon, and he will respond quickly.

What is the Success Rate of a pancreas transplant?

According to Beth Israel Deaconess Medical Center, the surgery is successful in about 90 percent of recipients within the first year following surgery and more than two-thirds after ten years.

Rejection Rate

Pancreas rejection rates are higher among Pancreas-only transplant recipients. The reason remains relatively unclear, although some studies have shown it may be because it is pretty challenging to monitor the progress of only a pancreas only transplant than a kidney-pancreas transplant.

How much does a Pancreas Transplant cost?

It is a delicate surgery; hence, expertise ensures its success. One can properly ascertain the cost after making proper consultation. You can learn more about it by contacting us at [email protected]

Where can you get a Pancreas Transplant?

Anavara has a wide connection with professional surgeons across the globe. We can connect with the best centers. Visit us at our website: www.anavara.com and email us for inquiries at [email protected]

FAQ

1. How much does the Pancreas Transplant cost?

Pancreas Transplant is a delicate surgery that requires many techniques to reduce the risk factors involved in this procedure. Hence, the correct cost is based on proper consultation with your doctor. Anavara can provide you with specialists that offer you services at an affordable cost. Contact us: [email protected]

2. What is the long-term outlook after Pancreas Transplantation?

It is a lifetime process and requires a long-time commitment to medications to suppress the immune system and reduce incidents of rejection. The recipients with successful transplantation have a better quality of life [7]. 

3. What is rejection?

Rejection is how the body’s immune system responds to things it considers foreign to its internal environment. For example, after the surgery, the body’s immune system can consider the new pancreas as a foreign object and attack it. However, drugs (immunosuppressants) are given to help suppress this reaction.

4. What happens when the transplanted pancreas fails?

If the transplant fails, the recipient has to return to regular management of diabetes with insulin and strictly monitor blood glucose levels. Another surgery is possible; however, the risk involved becomes higher with an increased rate of infections.

5. I have a mild case of diabetes that is easily controlled. Can I still perform a transplant?

It is advised not to undergo a pancreas transplant when you can easily control your diabetes due to its complications and long-term effects.

6. How do I find a reliable hospital with an excellent surgeon to perform the surgery?

 Anavara is ready to connect you through their connection with specialized professional surgeons and quality hospitals across the globe. Visit us at www.anavara.com

7. what is the success rate of a pancreas transplant?

In general, pancreas transplants are safe and effective, with a survival rate of >95% at one year and >88% in 5years. The graft survival rate is almost 85% at one year and >60% at five years. Overall, the estimated half-life of the pancreas is 7-14 years [5].

8. Who discovered pancreas transplant?

Kelly and Lillehei first did the pancreas transplant on December 17, 1966 [6].

9. Under what conditions should pancreas transplants be avoided?

People with the following conditions should avoid pancreatic transplant 

  • History of cancer
  • Patients with immunocompromised states such as AIDS, HIV, etc.
  • Lung diseases, obesity, severe heart diseases, infections such as hepatitis, etc.
  • Blood vessel diseases.

References

  1. https://www.mayoclinic.org/tests-procedures/pancreas-transplant/about/pac-20384783
  2. Burke GW 3rd, Vendrame F, Virdi SK, Ciancio G, Chen L, Ruiz P, et al. Lessons from Pancreas Transplantation in Type 1 Diabetes: Recurrence of Islet Autoimmunity. Curr Diab Rep. 2015 Dec. 15 (12):121.
  3. Kerr HR, Hatipoglu B, Krishnamurthi V. Pancreas transplant for diabetes mellitus. Cleve Clin J Med. 2015 Nov. 82 (11):738-44.
  4. https://emedicine.medscape.com/article/429408-treatment#d2.
  5. https://pubmed.ncbi.nlm.nih.gov/23897173/#:~:text=Nevertheless%2C%20pancreas%20transplants%20are%20safe,is%20now%207%2D14%20years.
  6. https://www.sciencedirect.com/science/article/pii/B9780128148334000010#:~:text=Since%20the%20first%20pancreas%20transplant,transplants%20have%20been%20performed%20worldwide.
  7. https://www.medicinenet.com/what_is_the_success_rate_of_a_pancreas_transplant/article.htm.