What is Pancreas Transplant ?
The pancreas is a tiny organ found near the stomach, intestines, and other organs in the abdomen. It's about the size of a palm. It is behind the stomach and in front of the spine. The pancreas produces digestive juices as well as hormones such as insulin and glucagon, which help the body keep blood sugar levels in check and use and store food energy.
A pancreas transplant is an organ transplant in which a healthy (insulin-producing) pancreas is placed into someone whose pancreas is no longer producing adequate insulin. The healthy pancreas comes from a deceased donor or a partial pancreas from a living donor.
A pancreas transplant may be used to treat type 1 or insulin-dependent diabetes. A successful pancreas transplant will eliminate the requirement for insulin shots, as well as diabetes-related dietary and exercise restrictions, as well as the danger of severe low blood sugar reactions. A pancreas transplant can also help manage damage to other organs caused by type 1 diabetes, such as the kidneys, or eyes.
There are three main types of pancreas transplantation:
Pancreas Transplant Alone- For patients with type 1 diabetes who have severe, frequent hypoglycemia but good kidney function, pancreas transplant alone is a good option.
Simultaneous pancreas-kidney transplant (SPK)- When the pancreas and kidney are transplanted from the same deceased donor at the same time, this is known as a simultaneous pancreas-kidney transplant (SPK). End-stage renal disease (ESRD) or end-stage kidney disease, which may require a kidney transplant, is one of the most devastating complications of type 1 diabetes. You must take antirejection medication for the kidney and continue to take insulin if you have a kidney transplant without a pancreas transplant. Diabetes has the potential to harm the new kidney as well as other organs. Successful combined kidney-pancreas transplants reduce diabetes deterioration and eliminate the requirement for insulin therapy in newly transplanted kidneys. A patient's replacement kidney and pancreas would come from the same donor in the best-case scenario.
Pancreas-after-kidney transplant (PAK)- When a cadaveric, or deceased, donor pancreatic transplant is performed after a previous, and different, living or deceased donor kidney transplant, it is known as pancreas-after-kidney transplant (PAK).
When is Pancreas Transplant required?
A pancreas transplant may be considered a possible treatment option if one or more of the following apply.
- Standard treatment for type 1 diabetes isn't working.
- Severe insulin reactions are common.
- Blood sugar management is really bad.
- Hypoglycemia Unconsciousness (see above)
- Kidney impairment that is severe
How is Pancreas Transplant done?
Evaluation and matching procedure:
Finding a donor can be difficult at times. The pancreas is frequently removed from someone who has been certified brain dead but is still on life support. The donor must meet certain transplant requirements, such as being healthy and of a certain age. The donor's organ must also be immunologically compatible with the recipient's body. To lower the chance of organ rejection, this is critical.
The pancreas can also be obtained from a living donor if a matching blood relative is willing to donate part of their pancreas. In these circumstances, donors donate a portion of their pancreas rather than the entire organ.
Both the patient and the donor are evaluated and put through a battery of tests prior to the transplant surgery to determine that the donor is healthy enough to survive the procedure. The exam comprises blood tests as well as compatibility matching. EKG, Echo, Chest X-ray, Abdominal CT scan, CT Cholangiogram, physical assessment by a physician, hepatologist, and psychiatric exams are among the additional tests and investigations.
Pancreas transplant surgery with living donor:
Depending on whether you are getting a pancreatic transplant alone or a kidney and pancreas transplant at the same time, pancreas transplant surgery normally takes three to six hours.
The donor's pancreas is first surgically removed-a part of the body and tail of the pancreas is removed.
Step 1
The first step is to make an incision down the center of your abdomen. The new pancreas and a little section of the donor's small intestine are surgically implanted into your lower belly.
Step 2
Your small intestine or gall bladder are joined to the donor intestine, and the donor pancreas is connected to blood arteries that also feed blood to your legs. To help digestion, your own pancreas is left in place.
Step 3
If you're also getting a kidney transplant, the new kidney's blood vessels will be connected to blood vessels in your lower belly. The ureter - the tube that connects the kidney to the bladder - of the new kidney will be linked to your bladder.
What is the Recovery after Pancreas Transplant like?
The recovery process following a pancreas transplant is a long and gradual one that tries to gradually improve the patient's health and fitness. Resuming normal daily activities could take up to three months.
You'll need to travel to India approximately 2-3 weeks before the surgery for pre-operative testing and paperwork, and you'll need to stay for around 6-8 weeks afterward. As a result, you'll need about 12-14 weeks to fully recuperate from pancreatic transplant surgery in India.
Your replacement pancreas should begin working right away, and your old pancreatic will continue to operate normally.
If you receive a new kidney, it will produce urine in the same way that your healthy kidneys did. This usually begins right away. However, it may take several weeks to return to normal pee production in certain circumstances.
Close monitoring is required for three to four weeks after you leave the hospital. Following your pancreas transplant, you'll need to take a number of medications. Immunosuppressants are medications that prevent your immune system from attacking your replacement pancreas.
What Results Can I Expect from Pancreas Transplant ?
After a successful pancreas transplant, your new pancreas will make the insulin your body needs, so you'll no longer need insulin therapy to treat type 1 diabetes.
Diabetes cure rate is 80% at 10-years and the chances of a diabetic being alive at 25 years after a simultaneous kidney pancreas transplant is 70% versus 27% if the diabetic went in for a kidney transplant alone.
