What to Expect with a Pancreatic Transplant

Your pancreas has the important job of creating insulin for your body.  Insulin is the hormone responsible for regulating the absorption of sugar into your cells to be used for things such as energy.

The pancreas also ensures that your body’s sugar levels do not get too high.  Basically, your pancreas is the organ in charge of keeping a perfect sugar balance.

If your pancreas does not make enough insulin to regulate your body’s sugar levels, you run the risk of developing type I diabetes.  Type I diabetes is a result of excess sugar in the body and causes a lot of health issues you must contend with.

One of the most serious health issues for those with type I diabetes are at risk for is kidney failure.  It is not surprising to know that with kidney disease comes illness.  And, if your kidneys fail all together, it can be fatal.

It is also not surprising to see many patients undergo a pancreatic transplant surgery along with a kidney transplant to replace all of the diseased organs.

Today, we are going to explore the sometimes extreme, although sometimes necessary, procedure of a pancreatic transplant.  Typically designated for patients fighting type I diabetes that are also suffering from severe kidney issues, a pancreatic transplant is a complicated and risky procedure.


What is a Pancreatic Transplant?

In short, a pancreatic transplant is a surgery in which a healthy donor pancreas is implanted into an ill patient with a non-functioning pancreas.  This is a specialized procedure and is performed by a pancreatic surgeon.

Although seemingly morbid, in order to keep the donor pancreas healthy, it is removed from the donor while the donor is brain dead, but is still on life support.  It is then transported in a cooler to keep it safe and healthy and is transported to the facility where the patient receiving the organ is waiting.

In addition, the donor’s blood type must be compatible with the patient receiving the organ so that the body has a better chance of accepting the organ.

During a pancreatic transplant, the diseased pancreas is not removed during the operation.  This is because it is still capable of making the essential digestive enzymes needed during the digestion of food. Instead, the donor pancreas is placed below the diseased pancreas and is attached to the patient’s blood vessels.


3 Types of Pancreatic Transplants

dr-mark-fraiman-pancreatic-transplant-baltimore-mdThere are three types of pancreatic transplant options that may be presented to you by your Baltimore pancreatic surgeon, should you and your physician feel there are no other treatment options:

  • Combined kidney-pancreas transplant – As stated earlier, sometimes a kidney transplant is required for those suffering from type I diabetes as well as renal failure. Often, the pancreas and kidney(s) will come from the same donor and be transplanted at the same time.
  • “Pancreas-after- kidney” transplant – This is very similar to a combined kidney-pancreas transplant, although the surgeries take place at separate times. In this case, the pancreas and kidney(s) will come from different donors.  This is because donor organs have a small window of time, often a matter of hours, to get transplanted before organ death occurs.
  • Pancreas transplant alone – Pancreas transplants that do not require kidney transplants are for those who have severe type I diabetes but are not having any type of kidney failure.


The Advantages of a Pancreas Transplant

There is much to be gained from receiving a healthy pancreas, especially if you are suffering from extreme renal disease:

  • With a healthy pancreas, you may no longer require insulin injections that result from your type I diabetes. The new pancreas will take on the role of insulin production and keep your body’s sugar balanced.
  • Many of your type I diabetes symptoms may lessen or go away altogether with the presence of a healthy pancreas that is functioning as it was meant to.
  • A healthy pancreas will prevent further damage to your already unhealthy kidneys or work well with the new kidney(s) you receive, should you require a kidney transplant as well.


The Risks of a Pancreas Transplant

As mentioned earlier, a pancreatic transplant is not a surgery to take lightly.  It must be performed by an expert pancreatic surgeon and is reserved for those patients that are nearing the end of their options when it comes to regaining their health.

Here is a look at some of the possible risks and/or complications that may result from a pancreas transplant:

  • Your body may reject the new organ as a foreign object, attack it, and render it useless.
  • You will have to take powerful immunosuppressant drugs for the rest of your life to help prevent your body from rejecting the new organ. These drugs can lower your immune system and trigger cancer, bacterial, and viral infections.
  • Since 75% of all pancreas transplants are performed with kidney transplants, complications post-surgery are higher, as well as rejection of the new organs.


The “Hows” Behind a Pancreas Transplant


There are many questions surrounding the risky pancreatic surgery.  Let’s take a look at some of the most common ones patients or concerned family and friends may have for their Baltimore pancreatic surgeon.


  1. How long is the wait for a pancreatic transplant?

The average wait time for a donor pancreas is anywhere between 6 months and 2 years.  Factors such as age, donor matching, and your medication situation all play a role in how long it takes for you to get a donor pancreas.

The healthier you are before your transplant, the higher the success rate your transplant will be.


  1. How do you start the transplant process?

If you are considering a pancreas transplant, the most important thing you can do is talk with your local Baltimore pancreatic surgeon.

A pancreatic specialist, such as Dr. Mark Fraiman from the Liver and Pancreas Center in Baltimore, will be able to help you decide whether a pancreatic transplant is the right treatment for your body.  From there, your pancreas physician will help you get on the national transplant waiting list.


  1. How much does a pancreatic transplant cost?

Every medical facility will have their own policies regarding cost for a pancreas transplant.

There are numbers that estimate a pancreas-only transplant will run approximately $125,800 during the first year.  That said, this often includes many things: evaluation, donor organ procedures, physician fees, transplant fees, follow-up care, and anti-rejection medications.

However, to help offset any costs not covered by your insurance, many facilities have programs with financial advisors on-hand to help.


  1. How does a pancreatic transplant evaluation work?

The benefits of having a pancreatic transplant must significantly outweigh the risk of having the surgery performed for it to even be an option.  This is because pancreatic transplant surgery is so complex and risky.

Here are some common things your pancreatic surgeon will test while evaluating whether you are a good transplant candidate:

  • Any disease that may worsen with surgery, such as amputation complications, vascular disease, or coronary artery disease
  • Urine and blood tests to determine the severity of your type I diabetes
  • Heart and lung strength
  • Stomach and digestion process after eating
  • Nerve function
  • Psychological factors that may hinder recovery and after care

If your health is in good standing (except for the diabetes, pancreas, and possibly kidney complications), your physician will likely place you on the transplant waiting list if this is the treatment option you decide on together.

In the end, there are many questions to be asked when it comes to something as serious as a pancreas transplant.  It is important you feel comfortable discussing anything with your pancreatic surgeon before following through with this type of major operation.


Final Thoughts

The truth is, there is a lot that goes into whether or not you should seriously consider a pancreatic transplant.  These types of decisions are not to be taken lightly and should involve an expert pancreatic surgeon who has years of experience dealing with a variety of transplant cases.

If you are in the Baltimore area and are looking for one such pancreatic surgeon, consider contacting Dr. Mark Fraiman.  Not only is he highly experienced in pancreatic surgery, he is one of the few specialists in the area that can even perform such complex procedures.  He will be able to discuss with you all of your options and individualize a plan geared towards making you the healthiest you can be.


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