Pancreas Transplant

Pancreas Transplant Process

Pancreas transplantation involves more than an operation. Evaluation, waiting for transplant, and recovery following surgery are all part of a long journey for the transplant candidate and family. Even after full recovery, some lifestyle changes are necessary for continued health after transplantation.

Preparation

Each pancreas transplant candidate must have an evaluation to determine whether transplantation is likely to be safe and beneficial. This pre-transplant evaluation commonly includes:

• Blood tests, including tissue type analysis
• Chest X-ray
• Electrocardiogram, and other heart testing in some cases
• Meeting with endocrinologists specializing in diabetes
• Meeting with nephrologists specializing in kidney-pancreas transplantation
• Meeting with a transplant surgeon

Tests performed by health-care facilities other than Mayo Clinic are often acceptable. Typically, a patient stays at Mayo Clinic for two days to complete this evaluation.

Transplant Surgery

During pancreas-transplant surgery, an incision is made down the center of the transplant recipient's abdomen. The donor pancreas is placed near the bladder in the middle or right side of the pelvis, along with a small portion of donor intestine. Surgeons usually attach the donor intestine to the recipient's bladder, allowing enzymes from the new pancreas to pass into the recipient's urine. Surgeons restore blood supply to the donor pancreas by connecting it to blood vessels supplying the recipient's legs.

The patient's own pancreas does not need to be removed. Although it cannot produce insulin, the original pancreas continues to perform other functions that aid in digestion.

The operation typically takes about three hours. The recipient typically gets out of bed and takes a short walk the day after surgery. Liquids can be sipped the day of surgery, and a normal diet is usually resumed within two to three days. During recovery, most patients gradually experience less discomfort in the incision and a greater ability to move around and return to normal activities. The donor pancreas should begin to function immediately, and patients typically remain in the hospital for about one week.

After Transplant

Because each individual is unique, we can only address this important issue in the broadest terms here. During visits with Mayo Clinic staff, patients will have ample opportunity to discuss their specific situations with many experienced professionals. The following general information usually applies:

• After-hospital care at Mayo Clinic
  After dismissal from the hospital, transplant recipients need to stay near Mayo Clinic for approximately three to four weeks so Mayo staff can monitor the function of the new pancreas and the patient's recovery after surgery. During that time, transplant recipients make regular visits to see the medical and surgical staff, as well as the transplant coordinators.
  
  
• Care at home
  When the recipient returns home, our staff will update local health care providers about the patient's progress and our recommendations. Once home, transplant recipients can see the health care providers of their choice, with Mayo staff ready to provide consultation or support as necessary.
  
  Follow-up appointments at Mayo Clinic are sometimes necessary during the first year after surgery, and some patients are asked to return annually. Our staff is always available if problems arise, either for communication or a return visit.
  
  
• Long-term health issues
  Within three to six weeks after surgery, most pancreas transplant recipients are capable of resuming their usual daily activities, including returning to work. Mayo's transplant nurse coordinators will remain in close contact with the transplant recipient and the local physician, who provides regular care at home. Pancreas transplant recipients must carefully follow the treatment plan developed in cooperation with their physician and the Mayo transplant team.
  
  
• Medications
  We expect all transplant recipients to need lifelong treatment with immunosuppressant medicines to prevent rejection of the transplanted pancreas. These medications must be taken daily following surgery.
  
  Our choice of medicines is based on the patient's personal medical history, as well as the combined experience of our transplant team in preventing and controlling transplant rejection. Some patients experience side effects from their medication, but we have excellent success in finding an acceptable treatment plan in most cases.