Pancreas Transplantation is a procedure to surgically remove a damaged or diseased pancreas and replace with a healthy pancreas, from a compatible donor. Pancreas Transplantation procedure is classified into four types: Pancreas Transplant Alone (PTA) procedure Simultaneous Pancreas-Kidney Transplant (SPK) procedure Pancreas After Kidney Transplant (PAK) procedure and Pancreas Transplant (pancreas obtained from a deceased donor) along with a Kidney Transplant (kidney obtained from a living donor).
A pancreas transplant is not performed if you have an advanced stage of cancer HIV infection severe heart failure longstanding and constant drug abuse or an advanced liver fibrosis and liver failure.
What are the reasons behind pancreas transplantation?
Pancreas Transplantation procedure is performed for the following reasons:
How pancreas transplantation is performed?
- Preventing complications associated with severe diabetes, such as kidney failure (diabetic nephropathy) and injury to the retinas (diabetic retinopathy)
- The procedure is typically performed in individuals who have insulin-dependent diabetes i.e., mostly in those who have type 1 diabetes with end-stage kidney disease. In such cases, the Pancreas Transplantation procedure is usually performed along with a kidney transplant
- The Pancreas Transplantation procedure is performed under general anaesthesia.
- The pancreas and a portion of the small intestine (duodenum) are removed from a suitable donor
- The surgeon makes an incision on the abdomen of the patient
- Leaving the original pancreas intact, the donor pancreas and small intestine are placed in the abdomen of the recipient
- The small intestine may be connected either to the intestine or to the bladder of the recipient
- The blood vessels are connected to the transplanted organs
- Sometimes, the patient may simultaneously undergo a kidney transplant
- The abdomen is then closed in layers
with experience, training and specialisation in pancreas transplantation surgery performs the procedure. It may take up to 3 hours for the procedure to complete.
Preparations needed before pancreas transplantation
Risks and complications during pancreas transplantation surgical procedure
- The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
- Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
- Blood tests may be performed to determine, if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
- Do inform the physician if you are allergic to any local anaesthetics, lidocaine, etc.
- Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
- It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
- Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
- The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
- For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines
The possible risks or complications that may arise during the pancreas transplantation surgery are:
Risks and complications after pancreas transplantation surgical procedure
- Excessive bleeding
- Thrombosis of blood vessels
- Infection in the surgical wound
- Anaesthetic complications
- Donor pancreas rejects its new host
- Failure of new donor pancreas to function normally at first
- Acute pancreatitis
After pancreas transplantation procedure the following complications may arise:
Post-operative care needed after pancreas transplantation surgical procedure
- Excessive bleeding
- Infection in the surgical wound
- Donor liver rejects its new host
- Bowel leakage
- Pancreatic fistula
At home, the following post-operative care is recommended after a pancreas transplantation procedure:
- Slowly resume daily activities as early as possible, which aids in faster recovery
- Use a heat pad or warm compress to relieve pain due to the incision
- Resume showering and keep the wound clean and dry. Avoid taking baths until the surgical wound is completely healed. Gently wash the surgical wound with unscented soap and re-bandage the wound again
- Elevate legs while resting to prevent the formation of blood clots and reduce the possibility of swelling
- Take stool softeners to prevent constipation (under advice of the physician)
- Take antibiotic medication to help combat or prevent infection (per the physician’s advice)
- Complete the course of prescribed medication under advice of the physician
- Per physician’s advice, take immunosuppressant medications to reduce the possibility of rejection
- Avoid taking non-prescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain, per the physician’s advise
- Avoid all activities that are physically strenuous for about 6 months, or for a period as advised by your physician