Double Blessed: Improving Quality of Life with a Kidney and Pancreas Transplant
July 15, 2024
4 minute read
After years of living with type 1 diabetes and kidney failure, Tracy Phelan, of Appleton, is enjoying renewed health and normal blood sugar levels, thanks to a simultaneous kidney-pancreas transplant by the Froedtert & the Medical College of Wisconsin transplant team. The transplant means she no longer must rely on insulin or dialysis. Her energy is back and she is still a little surprised to discover her blood sugar levels are normal when she checks them on a whim.
“It’s huge because it changed my life in a short amount of time,” Tracy said.
Tracy, 40, was diagnosed with type 1 diabetes when she was a teen. In type 1 diabetes, the pancreas can no longer produce insulin, a substance that regulates blood sugar in the body. Patients must take insulin through injections or a pump, but even that cannot always replicate the work of a healthy pancreas. Over time, diabetes can lead to heart failure, poor circulation and, as Tracy discovered, kidney damage and kidney failure.
By 2020, Tracy’s kidneys failed to the point where she needed dialysis three times a week. When doctors talked to her about the possibility of a simultaneous kidney-pancreas transplant, she was on board right away. In October 2023, Tracy received the transplant. Her new pancreas went right to work, restoring her blood sugar levels to normal.
“Simultaneous kidney-pancreas transplants were first done in the 1960s, but they became more commonplace in the 1990s,” said Ty Dunn, MD, MS, transplant surgeon, surgical director of the Kidney and Pancreas Transplant Programs and MCW faculty member.
During the procedure, which can last five to eight hours, surgeons transplant a kidney and pancreas from the same deceased donor into the patient. Afterwards, patients can expect to spend a week or so in the hospital as their body begins to heal and the new pancreas produces insulin on demand. The first three months may be especially demanding.
“It can be a tough early course of recovery, but patients typically do quite well,” Dr. Dunn said.
Although a simultaneous procedure is riskier and more extensive than a kidney transplant alone, the donor pancreas can lessen the burden on the new kidney. As with any procedure, complications can arise. Patients must commit to continued monitoring and to taking antirejection medications that may carry side effects, but these side effects may also occur with a kidney-only transplant.
“When you have to weigh someone’s risk of dying or having a disability from diabetes complications, you have to decide if a pancreas transplant is the best choice for the patient,” Dr. Dunn said.
“Tracy’s dual diagnosis of kidney failure and type 1 diabetes made her an ideal candidate for the simultaneous transplant,” said Rima Patel, DO, transplant nephrologist and MCW faculty member.
Patients must be willing to follow stringent aftercare requirements, including regular blood draws and lab work.
“I always tell my patients that we are doing the transplant to give them a better quality of life, so if anything is making them feel worse, there are different types of medications we can use posttransplant to improve the situation,” Dr. Patel said.
The health network recently expanded its nationally recognized transplant program, bringing in new physicians and surgeons, including Dr. Dunn and others. The expansion helped make Tracy’s simultaneous transplant possible.
“The additional medical resources have continued to strengthen the program,” said Terra Pearson, MD, transplant surgeon and MCW faculty member. “It’s also important to recognize that one of the reasons our patients do so well is that we have a dedicated transplant intensive care unit. That’s something not a lot of transplant centers have.”
The Froedtert & MCW Kidney and Pancreas Transplant Programs exceed the national average in patient and graft survival rates.1
While patients like Tracy should no longer need insulin, Dr. Dunn cautioned against using the word “cure,” which implies that patients are no longer diabetic. “Without a transplant, the recipient is not capable of making their own insulin, so they will always be diabetic,” Dr. Dunn said. “If the new pancreas isn’t working, they will need insulin.”
After a transplant, patients need to follow up regularly with their medical team to ensure the transplanted organs continue to function optimally.
Tracy is diligent about staying healthy. She looks forward to running faster than her 9-year-old son as she regains her energy.
“My goal is to keep these organs as long as I can,” Tracy said. “I’ve been reading stories where people have had transplanted organs for 30 to 50 years. I want that to be me.”
1Scientific Registry of Transplant Recipients, srtp.org, January 2024
