Pancreas Transplantation

Why is Pancreas Transplantation Performed?

Pancreas transplantation can be performed to ensure normal insulin production and improved blood sugar control in diabetic patients. However, pancreas transplantation should not be considered as standard treatment for diabetic patients.

If pancreas transplantation is successful, the patient may not need insulin anymore. In addition, advantages such as frequent daily blood sugar measurement and elimination of dietary restrictions can be provided. It is known that hypoglycemia and hyperglycemia attacks disappear in many patients after transplantation.

Pancreas transplantation is partially effective on complications seen in the kidney and nervous system in diabetic patients, but it does not completely eliminate the risk. In some cases, pancreas transplantation can also be performed for the treatment of Type 2 disease. In addition, transplantation may be preferred in the treatment of cancer types such as pancreatic cancer and bile duct cancer. Pancreas transplantation can be performed together with kidney transplantation, especially in patients with severe kidney damage due to diabetes.

How is Pancreas Transplantation Performed?

In organ transplantation processes, the donor is called the donor. Patients waiting for a pancreas transplant should be alert. Because the transplant should be performed within 18 to 24 hours after a suitable donor is found. Therefore, patients waiting for a pancreas transplant should be able to go to the hospital as soon as possible after their doctors reach them.

General anesthesia is administered to the patient before the transplant surgery. In this way, the patient does not feel any pain or discomfort during the surgery. In addition, the patient is intubated during the surgery and their breathing continues with the machine connected.

After an incision is made down the middle of the abdomen, the pancreas taken from the donor and a small section of intestine are placed in the lower abdomen of the patient. The small section of intestine taken from the donor is sewn to the patient’s intestine or bladder. The pancreas taken from the donor is connected to the blood vessels going to the patient’s legs and its nutrition is provided. The ureter belonging to the transplanted kidney is connected to the bladder, and if there is no problem such as infection in the patient’s own kidneys, the old kidneys are left in place. Pancreas transplantation can take 3 to 6 hours, during which the patient’s pulse, breathing and blood pressure are kept under control.

In pancreas transplantation, the patient is kept in the intensive care unit for the next few days. In this way, it can be monitored whether any complications related to the surgery develop and whether the transplanted organs start to function.

When the patient is stabilized and discharged from intensive care, he/she is taken to the ward. Here, he/she is monitored on one hand, while waiting for the surgical wounds to heal. During the recovery process, the patient should be able to stand up and walk and gain skills such as going to the toilet on his/her own.

The patient is closely monitored for 3 to 4 weeks after discharge. After the transplant, patients take immunosuppressive drugs for life. In this way, the patient’s immune system can be prevented from attacking and damaging the new pancreas.

If the pancreas transplantation is successful, the need for Type 1 diabetes patients to continue insulin treatment is eliminated. Even if there is a high level of compatibility between the patient and the donor, there is a risk of a condition called organ rejection. Organ rejection is a condition that occurs when the patient’s immune system perceives the newly transplanted pancreas as foreign and attacks it. Symptoms such as abdominal pain, fever, increased blood sugar, extreme sensitivity in the transplant area, vomiting and decreased urine production may occur due to pancreatic rejection.

Who Can Have Pancreas Transplantation?

Pancreas transplantation is usually performed in patients with Type 1 diabetes to allow them to produce insulin again. People with Type 1 diabetes have very little or no insulin. These patients need to take insulin externally every day. However, they cannot be protected from the long-term complications of diabetes. Pancreas transplantation is not performed on all patients with diabetes because it is a risky surgery.

Suitable patients for pancreas transplantation can be listed as follows:

Patients with Type 1 diabetes that cannot be controlled with standard treatment

Patients who have a very severe reaction to insulin

Patients with poor blood sugar control despite insulin

Patients who experience severe and uncontrollable hypoglycemia attacks

Patients who have developed severe kidney damage

However;

Pancreas transplantation cannot be performed on those with a history of cancer
HIV/AIDS patients
Those with severe lung disease
Patients with active hepatitis
Those with obesity
Those with blockage in the neck and leg veins
Those who are smokers, alcoholists and drug addicts.