Since the majority of pancreas transplant patients suffer from Type 1 diabetes, care is provided in collaboration with the experts in diabetes mellitus, end-stage kidney disease and kidney transplant at Froedtert Hospital.
Preparing for Pancreas Transplant Surgery
Once other treatment options are exhausted, patients undergo a thorough evaluation to confirm that they are healthy enough for pancreas transplant. The evaluation process includes psychological and social assessments, blood tests and several diagnostic tests. Once accepted for transplant, patients are placed on the waiting list for a donor pancreas. If a kidney transplant is planned as part of the procedure, arrangements for securing a deceased or live donor also are made.
Transplant coordinators work with patients to schedule tests, educate them about the pancreas transplant process, set expectations and prepare them for life after pancreas transplant. If desired, coordinators can connect patients with others who have experienced pancreas transplant. Financial counselors, registered dietitians and transplant psychologists, all part of the transplant care team, are available to offer insights and support.
For patients requiring kidney transplant who have a live donor, surgery is scheduled. Patients on the waiting list are notified when a deceased donor pancreas (and kidney, if needed) becomes available, and patients are asked to get to the hospital as soon as possible.
Pancreas Transplant Surgery
Pancreas transplant surgery lasts three to four hours if performed alone or after kidney transplant. If a kidney transplant is performed simultaneously, the procedure may take four to six hours or more.
Surgery is conducted by a multidisciplinary team of experienced transplant surgeons, anesthesiologists, nurses, technicians and other professionals. If the patient is receiving a kidney, too, from a living donor, the recipient and donor are in surgery at the same time. One surgery team removes the donor kidney and another team prepares the recipient to receive the donation.
Pancreas transplant surgery has several steps:
- Before surgery, patients are given general anesthesia, so they are unconscious through the procedure.
- Once the anesthesia takes effect, the transplant surgeon makes an incision in the center of the abdomen.
- The donated pancreas and a small segment of the donor’s small intestine then are placed into the lower abdomen. The surgeon attaches the donated intestine to the small intestine or bladder, and connects the new pancreas to the blood supply.
- The patient’s original pancreas is left in place.
- If the patient is also receiving a kidney transplant, the donated kidney is then placed in the abdomen and attached to the patient’s blood supply. The new kidney’s ureter is connected to the bladder. Unless the original kidneys are causing infection or complications, they are left in place, too.
- Once all of the connections are made, the surgeon closes the incision and the patient is moved to a recovery area.
Recovery From Pancreas Transplant Surgery
After pancreas transplant, patients spend a few days recovering in a dedicated transplant intensive care unit (TICU) staffed by nurses specially trained in caring for transplant patients. Complications from pancreas transplant are rare, but patients can expect to feel pain or discomfort associated with the incision. Our nurses and staff do all they can to control pain and keep patients comfortable.
After a transplant, patients are seen daily by transplant nephrologists for the medical component of their care, and by surgeons for post-surgical care.
Long-Term Care After Pancreas Transplant
As part of the pancreas transplant process, the care team requests frequent checkups during the first three to four weeks after a patient goes home from the hospital, so patients may need to make arrangements to stay nearby.
For the rest of the patient’s life after receiving a new pancreas, he or she must be committed to nutrition, an active lifestyle and a strict medication schedule, including anti-rejection drugs (immunosuppressants). Immunosuppressants help protect the new organ or organs from being rejected by the body’s immune system.
Froedtert Hospital’s Transplant Clinic offers multidisciplinary follow-up care in a convenient and centralized location. Transplant coordinators dedicated to post-transplant care work with patients to coordinate their follow-up transplant care.
