A pancreas transplant can restore normal insulin production and improve blood sugar control in people with diabetes, but it's not a standard treatment. The side effects of the anti-rejection medications required after a pancreas transplant can often be serious.
For people with any of the following, a pancreas transplant may be worth considering:
- Type 1 diabetes that can't be controlled with standard treatment
- Frequent insulin reactions
- Consistently poor blood sugar control
- Severe kidney damage
- Type 2 diabetes associated with both low insulin resistance and low insulin production
A pancreas transplant usually isn't a treatment option for people with type 2 diabetes, because type 2 diabetes occurs when the body becomes resistant to insulin or unable to use it properly rather than due to a problem with insulin production in the pancreas.
But for some people with type 2 diabetes who have both low insulin resistance and low insulin production, pancreas transplant is an emerging treatment option. About 10 percent of all pancreas transplants are performed in people with type 2 diabetes.
There are several different types of pancreas transplants, including:
- Pancreas transplant alone. People with diabetes and early or no kidney disease may be candidates for a pancreas transplant alone (solitary pancreas transplant). A pancreas transplant surgery involves only a pancreas transplant without other surgeries.
Combined kidney-pancreas transplant. Surgeons often may perform combined (simultaneous) kidney-pancreas transplants for people with diabetes who have or are at risk of kidney damage. More than two-thirds of pancreas transplants are done simultaneously with a kidney transplant.
The goal of this approach is to give you a healthy kidney and pancreas that are unlikely to contribute to diabetes-related kidney damage in the future. But waiting for a donor pancreas and kidney to become available at the same time may increase time spent on the organ donor waiting list.
Pancreas-after-kidney transplant. For those facing a long wait for both a donor kidney and pancreas to become available, a kidney transplant may be recommended first if a living- or deceased-donor kidney becomes available.
After you recover from kidney transplant surgery, you'll receive the pancreas transplant once a donor pancreas becomes available.
Pancreatic islet cell transplant. During pancreatic islet cell transplantation, insulin-producing cells (islet cells) taken from a deceased donor's pancreas are injected into a vein that takes blood to your liver. More than one injection of transplanted islet cells is often necessary.
Islet cell transplantation is an experimental procedure and may only be performed as part of a Food and Drug Administration-approved clinical trial.
Although it's possible for a living donor to donate part of a pancreas, nearly all pancreas transplants involve a deceased-donor pancreas.
Aug. 19, 2017
- Klein CL, et al. Patient selection for and immunologic issues relating to kidney-pancreas transplantation in diabetes mellitus. http://www.uptodate.com/home. Accessed March 21, 2016.
- Klein C, et al. Benefits and complications associated with kidney-pancreas transplantation in diabetes mellitus. http://www.uptodate.com/home. Accessed March 21, 2016.
- Pancreas transplantation. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/transplantation/pancreas-transplantation.html. Accessed March 21, 2016.
- Robertson RP. Pancreas and islet transplantation in diabetes mellitus. http://www.uptodate.com/home. Accessed March 21, 2016.
- Health after transplantation. American Society of Transplantation. http://www.healthytransplant.com/health_maintenance/health_after_transplantation.aspx Accessed March 22, 2016.
- Preparing for the transplant. American Society of Transplantation. http://www.healthytransplant.com/health_maintenance/preparing_for_transplant.aspx. Accessed March 22, 2016.
- Kidney-pancreas transplant. National Kidney Foundation. http://www.kidney.org/atoz/content/kidpantx.cfm. Accessed March 22, 2016.
- Scientific Registry of Transplant Recipients 2012 Annual Data Report: Pancreas. Health Resources and Services Administration.
http://srtr.transplant.hrsa.gov/annual_reports/2012. Accessed April 12, 2016.
- Chakkera HA (expert opinion). Mayo Clinic, Phoenix, Arizona. April 12, 2016.
- Side effects. UNOS Transplant Living. http://transplantliving.org/after-the-transplant/medications/side-effects/. Accessed March 22, 2016.
- Pancreas transplant. National Kidney Foundation. https://www.kidney.org/atoz/content/pancreastx. Accessed March 22, 2016.
- Heilman RL, et al. Immunosuppression in simultaneous pancreas-kidney transplantation. Drugs. 2010;70:793.
- Kandaswamy R, et al. Pancreas. American Journal of Transplantation. 2016;16(suppl 2):47.
- Pancreas. Organ Procurement and Transplantation Network. https://optn.transplant.hrsa.gov/data/organ-datasource/pancreas/. Accessed March 23, 2016.
- Barbara Woodward Lips Patient Education Center. Pancreas transplant. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Pancreas. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0015631/. Accessed April 7, 2016.
- Guidance for industry: Considerations for allogeneic pancreatic islet cell products. U.S. Food and Drug Administration. http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/CellularandGeneTherapy/ucm182440.htm. Accessed March 28, 2016.
- Pancreatic islet transplantation. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/pancreatic-islet-transplantation/Pages/index.aspx. Accessed March 28, 2016.
- Kudva YC, et al. Comprehensive immune monitoring reveals profound immunological changes in pancreas after kidney (PAK) transplant recipients. Human Immunology. 2013;74:738.
- Reddy KS, et al. Alemtuzumab with rapid steroid taper in simultaneous kidney and pancreas transplantation: Comparison to induction with antithymocyte globulin. Transplantation Proceedings. 2010;42:2006.
- Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. April 6, 2016.
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