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By Mayo Clinic staff
During a pancreas transplant
Surgeons perform pancreas transplants using general anesthesia, so you're unconscious during the procedure. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein.
The surgical team monitors your heart rate, blood pressure and blood oxygen throughout the procedure with a blood pressure cuff on your arm and heart-monitor leads attached to your chest. After you're unconscious:
- The surgeon places the new pancreas and a small portion of the donor's small intestine into your lower abdomen.
- The donor intestine is attached to either your small intestine or your bladder, and the donor pancreas is connected to blood vessels that supply blood to your legs.
- Your own pancreas is left in place to aid digestion.
- If you're also receiving a kidney transplant, the blood vessels of the new kidney will be attached to blood vessels in the lower part of your abdomen.
- The new kidney's ureter — the tube that links the kidney to the bladder — will be connected to your bladder. Unless your own kidneys are causing complications such as high blood pressure or infection, they are left in place.
Pancreas transplant surgery usually lasts about three hours. Simultaneous kidney-pancreas transplant surgery takes a few more hours.
After a pancreas transplant
After your pancreas transplant, you can expect to:
- Stay in the intensive care unit for a few days. Doctors and nurses monitor your condition to watch for signs of complications. Your new pancreas should start working immediately, and your old pancreas will continue to perform its other functions. If you have a new kidney, it'll make urine just like your own kidneys did when they were healthy. Often this starts immediately. But in some cases, urine production takes up to a few weeks.
- Spend about 1 week in the hospital. Once you're stable, you're taken to a transplant recovery area to continue recuperating. Expect soreness or pain around the incision site while you're healing.
- Have frequent checkups as you continue recovering. After you leave the hospital, close monitoring is necessary for three to four weeks. Your transplant team will develop a checkup schedule that's right for you. During this time, if you live in another town, you may need to make arrangements to stay close to the transplant center.
- Take lifelong medications. You'll take a number of medications after your pancreas transplant. Drugs called immunosuppressants help keep your immune system from attacking your new pancreas. Additional drugs may help reduce the risk of other complications, such as infection and high blood pressure, after your transplant.
References
- Humar A, et al. Transplantation. In: Brunicardi FC, et al. Schwartz's Principles of Surgery. 8th ed. New York, N.Y.: McGraw-Hill Companies; 2005. http://www.accessmedicine.com/content.aspx?aID=799511. Accessed June 24, 2009.
- Robertson RP. Patient selection for and immunologic issues related to kidney-pancreas transplantation in diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed June 25, 2009.
- Pancreas Kaplan-Meier graft survival rates for transplants performed 1997-2004, by diagnosis. Organ Procurement and Transplantation Network. http://optn.transplant.hrsa.gov/latestData/rptStrat.asp. Accessed July 5, 2009.
- Facts about pancreas transplants. American Society of Transplantation. http://www.a-s-t.org/files/pdf/patient_education/english/AST-EdBroPANCREAS-ENG.pdf. Accessed June 30, 2009.
- American Diabetes Association position statement: Pancreas and islet transplantation in type 1 diabetes. Diabetes Care. 2006;29:935.
- Getting a kidney-pancreas transplant. National Kidney Foundation. http://www.kidney.org/atoz/atozItem.cfm?id=159. Accessed June 24, 2009.
- Robertson RP. Benefits and complications associated with kidney-pancreas transplantation in diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed June 25, 2009.
- Larson-Wadd K, et al. Pancreas and islet cell transplantation. Anesthesiology Clinics of North America. 2004;22:663.
- Coping with the physical side effects of anti-rejection medications. American Society of Transplantation. http://www.healthytransplant.com/index.php?q=quality_of_life/coping_with_the_physical_side_effect_of_anti-rejection_medications. Accessed July 5, 2009.
- Punch JD. Organ transplantation. In: Doherty GM, et al. Current Surgical Diagnosis & Treatment. 12th ed. New York, N.Y.: McGraw-Hill Companies; 2006. http://www.accessmedicine.com/content.aspx?aID=2066708. Accessed June 24, 2009.
- Robertson RP. Pancreas and islet transplantation in diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed June 25, 2009.
- OPTN/SRTR annual report: Adjusted graft survival by year of transplant at 3 months, 1 year, 3 years, 5 years and 10 years, kidney-pancreas transplants — pancreas graft. Scientific Registry of Transplant Recipients. http://www.ustransplant.org/annual_reports/current/809b_kp.htm. Accessed July 7, 2009.
- OPTN/SRTR annual report: Adjusted graft survival by year of transplant at 3 months, 1 year, 3 years, 5 years and 10 years, pancreas after kidney (PAK) transplants. Scientific Registry of Transplant Recipients. http://www.ustransplant.org/annual_reports/current/709_pak.htm. Accessed July 7, 2009.
- OPTN/SRTR annual report: Adjusted graft survival by year of transplant at 3 months, 1 year, 3 years, 5 years and 10 years, pancreas transplant alone (PTA) transplants. Scientific Registry of Transplant Recipients. http://www.ustransplant.org/annual_reports/current/609_pta.htm. Accessed July 7, 2009.
