Pancreas Transplant is a surgical procedure performed to replace a diseased pancreas with a healthy pancreas from a deceased donor. The transplant is usually done as a potential cure for type 1 diabetes, typically for people with serious complications of diabetes. It may be done along with a kidney transplant if there is damage to the kidneys because of the diabetes.
Fortis Hospitals Mumbai, Pancreas Transplant Department offers comprehensive care for patients of all age-groups requiring pancreas transplantation. Centre delivers modern diagnostic procedures to evaluate and treat patients with chronic conditions such as diabetes. Our surgeons have extensive experience in performing advanced pancreas transplantation techniques (PTA) including surgeries for patients with complex conditions needing multiorgan transplants such as simultaneous pancreas-kidney (SPK) and pancreas after kidney (PAK) transplantation.
Our transplant team utilises a collaborative approach working across experts in departments such as diabetology & endocrinology, nephrology, intensive care and oncology, to bring customised care for patients. Patient is actively involved in understanding the risks and benefits of the care plan, to enable a smooth transition post-transplant, to lead a longer, better quality of life. Pivotal to our pancreas transplant program is the psychosocial and mental wellbeing support, health education and advanced care accessible to the patient and the family throughout the clinical journey. We stand as a testimony to successful pancreas and kidney transplants with best surgical outcomes, at par with international standards.
Our multi-disciplinary pancreas transplant team ensuring personalised care:
Pancreas and Kidney Transplant Surgeons
Endocrinologists & Diabetologists
Paediatric Endocrinologists & Paediatric Nephrologists
Onco-endocrinologists & Onco-nephrologists
Dermatologists
Anaesthetists
Well-trained transplant nurses, transplant coordinators, social workers, psychologists and clinical nutritionists
The team is well supported by intensive care specialists, infectious diseases specialists, radiologists and clinical pharmacologists.
Pancreas is an organ that lies behind the lower part of the stomach. One of its main functions is to make insulin, a hormone that regulates the absorption of sugar (glucose) into human cells. If the pancreas does not make enough insulin, blood sugar levels can rise to unhealthy levels, resulting in type 1 diabetes. A pancreas transplant can restore normal insulin production and improve blood sugar in people with diabetes. However, the side effects of the transplant can be serious.
Doctors may consider people with the following conditions for a pancreas transplant:
Type 1 diabetes that is not getting 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
The risks associated with pancreas transplant include:
Bleeding
Blood clots
Excess sugar in the blood (hyperglycaemia) or other metabolic problems
Infection
Urinary complications including leaking or urinary tract infections
Failure or rejection of the donated pancreas
The risks associated include rejection of the donor organ as a normal reaction of the body’s immune system to attack a foreign object or tissue. The medications used to prevent or treat rejections have side-effects.
The anti-rejection or immunosuppressants cause variety of side-effects including:
Bone thinning (osteoporosis)
High blood pressure
High cholesterol
Nausea, diarrhoea or vomiting
Sensitivity to sunlight
Acne
Increased risk of cancer particularly skin cancer
Infection
Oedema (puffiness)
Swollen gums
Weight gain
Different types of pancreas transplants are available, including:
Pancreas transplant alone (PTA) - for patients with diabetes 1 and early or no kidney disease. The pancreas transplant is a surgical procedure in which a healthy pancreas is placed into a recipient whose pancreas is not functioning properly.
Simultaneous pancreas-kidney transplant (SPK) - procedure involves simultaneous pancreas and kidney transplantation. Patients with diabetes 1 and end stage renal disease undergo this procedure most commonly.
Pancreas-after-kidney transplant (PAK) - procedure involves a cadaveric or diseased donor pancreas transplant performed after a different, living/deceased donor kidney transplant. For patients who need to wait long for both a donor kidney and a donor pancreas to become available, a kidney transplant may be recommended first and post-recovery, once the pancreas becomes available, the second transplant is performed.
Patients need to be evaluated with additional tests and doctor consultations, to determine their eligibility for a pancreas transplant. The following points will be considered by the transplant team:
Is the patient healthy enough for the surgery and life-long medications that follow post-transplant?
Are there any medical conditions that may hinder success of the surgery?
Is the patient willing and able to follow the medication regime and recommendations made by the transplant team?
Once the tests are completed, the transplant team assesses the patient’s clinical condition to undergo the pancreas transplant. If the patient also needs a kidney transplant, the transplant team decides on the best treatment choice - whether to conduct pancreas and kidney transplants during the same surgery, or to have the kidney transplant first, followed by the pancreas transplant. This choice also depends on the availability of donors and patient’s preference.
Once the patient is accepted as a candidate for the pancreas transplant, he/she is placed on a waiting list for a donor pancreas. A donor-recipient match is dependent on the blood tissue type and the waiting time for a pancreas to become available is long.
During the long wait for a donated pancreas or a scheduled transplant surgery, it’s important to stay healthy. Leading an active and healthy lifestyle will aid in speedy recovery from surgery. Points to keep in mind:
Continue with medications, as prescribed
Follow diet and exercise guidelines
Stop smoking
Involving self in healthy activities, including relaxing and spending time with family and friends
Keep in regular touch with the care team including information on any significant changes in health.
During the procedure
Pancreas transplants are performed with general anaesthesia, so the patient is asleep during the procedure. The surgical team monitors heart rate, blood pressure and blood oxygen level throughout the procedure. During the surgery:
The surgeon makes an incision down the centre of the patient’s abdomen and places the new pancreas and a small portion of the donor's small intestine into the lower abdomen.
The donor intestine is attached to either the recipient’s small intestine or bladder, and the donor pancreas is connected to blood vessels that also supply blood to the legs.
Recipient’s pancreas is left in its place to aid digestion.
In case of a kidney transplant, the blood vessels of the new kidney will be attached to blood vessels in the lower part of recipient’s abdomen. Unless recipient’s kidneys are causing complications such as high blood pressure, kidney stones, pain or infection, they are left in place.
The blood vessels of the new kidney are attached to blood vessels in the lower part of the abdomen, just above one of the legs.
The new kidney's ureter (tube linking the kidney to the bladder) is connected to the recipient’s bladder.
Staying in the ICU - Healthcare team will monitor patient’s condition in the hospital's ICU for a few days to watch for signs of complications. The new pancreas should start working immediately and the old pancreas will perform its other functions. In case of a new kidney, it will make urine like they did when they were healthy. This also happens immediately, however in some cases it may take several days and temporary dialysis maybe needed till then. Most kidney transplant recipients can return to normal routine within eight weeks post the transplant.
Recovering in the hospital - Once the patient’s condition is stable, he/she is transferred to a transplant recovery area to continue recuperating.
Frequent check-ups - After leaving the hospital, close monitoring is necessary for a few weeks to evaluate if the new pancreas/kidney are functioning and there is no rejection by the body.
Life-long medications - a number of medications such as immunosuppressants (anti-rejection medications) and drugs to reduce the risk of other complications such as infection, blood pressure, post the transplant, will be prescribed.
Coping - seeking the support of friends and family members can help cope during this time. The transplant team may also assist in finding resources such as a support group for transplant recipients or rehabilitation services.
Diet - a clinical nutritionist on the transplant team will discuss nutritional needs to help reach and maintain a healthy weight through diet and exercise.
Exercise - exercise and physical activity should be a regular part of life to continue improving overall physical and mental health. The transplant team will advise a physical activity program based on individual needs and goals.
Fortis Hospital Mulund
Senior Consultant & Chief Surgeon - Liver Transplant & HPB Surgery
Fortis Hiranandani Hospital, Navi Mumbai
Senior Consultant & Chief Surgeon - Liver Transplant & HPB Surgery
