Do you or someone you know have diabetes and kidney failure? When that happens, life becomes very complicated, with insulin injections on one side and dialysis treatment on the other... But there is a special surgery that can solve both of these conditions at once. Today we are talking about the kidney and pancreas transplant surgery. Let's understand this simply.
What is a kidney and pancreas transplant?
Simply put, this means that both a healthy kidney and a healthy pancreas are transplanted into your body in a single surgery. Doctors also call this a Simultaneous Pancreas and Kidney (SPK) transplant .
This surgery is usually recommended for people with Type 1 diabetes and kidney failure. Kidney damage is common when diabetes is not properly controlled for years. So after this surgery, your body naturally regains its ability to produce insulin and your kidneys function normally again. Sometimes, this surgery can also be suitable for people with Type 2 diabetes .
But remember, not everyone can have this surgery because they have both of these conditions. If your doctor thinks you might benefit from it, he or she will refer you to a team of transplant specialists. They will examine you carefully and decide whether you are a good fit for this.
Who is eligible for this surgery?
If you are at risk of kidney failure or have already failed, and you also have Type 1 diabetes, your doctors may consider this surgery. When you are referred to an organ transplant center, a team of specialists, coordinators, and others will carefully examine you.
Before adding your name to the waiting list, they pay special attention to a few things.
| Consideration | Description |
|---|---|
| Overall health status | We will look at your general health, including whether you smoke or use drugs. |
| Medical history | You are being tested to see if you have cancer or other serious illnesses. |
| Physical and mental tests | A complete physical examination and a psychological test are performed to see if you are mentally prepared to face such a major surgery. |
| Function of organs | Special tests are performed to measure the function of major organs such as the kidneys, pancreas, heart, lungs, and bladder. |
Where do new kidneys and pancreases come from?
This is a problem for many people. A kidney can be obtained from a living donor. But a pancreas can only be obtained from a deceased donor. Therefore, in this SPK surgery, an attempt is usually made to obtain both organs from the same deceased donor.
Each donor is carefully screened to ensure they are free of infectious diseases or other complications, and to ensure they are a good match for your blood type and tissue type.
How long will we have to wait?
It is difficult to give an exact time frame for this. It can usually take 24-36 months (2-3 years). If someone has a rare blood type or tissue type, it may take even longer to find a matching donor.
Once you are determined to be a good fit, your name and medical information will be added to the national organ transplant waiting list. As soon as a matching donor becomes available, you will be notified. After that, everything happens very quickly. You will need to have surgery within 12 hours of the organ being removed from the donor's body.
How is the surgery done?
This surgery is performed under full anesthesia, meaning you won't feel anything.
1. Kidney transplant: The surgeon makes an incision in your lower abdomen. The first transplant is the kidney. The new kidney is placed in the lower right or left side of your abdomen and connected to your body's blood vessels (veins and arteries). Then the new kidney's ureter is connected to your bladder. That's where urine leaves your body. In most cases, your old, failing kidney is not removed.
2. Pancreas transplant: Next, the new pancreas is placed in the lower abdomen and connected to nearby blood vessels. The pancreatic juice, which is secreted by the pancreas and helps digest food, is returned to your digestive system, and the pancreas is connected to your small intestine. Like the kidneys, your old pancreas is usually not removed.
The new organ should start working within a few hours of the surgery. That means the new pancreas will start producing insulin and controlling your blood sugar levels. The surgery usually takes between 4 and 8 hours .
What are the benefits and risks of this surgery?
Like any major surgery, this one has both benefits and risks.
Main advantages
After a successful surgery, your strength, energy, and vitality will increase. You will be able to return to a normal life.
- Freedom from dialysis: If you had dialysis before the surgery, you will be free from the life that was tied to it.
- Insulin freedom: Because the new pancreas controls your blood sugar levels, you will likely never need insulin injections again.
- Improving the standard of living: Many people say that the overall standard of living is improving a lot.
Risks and complications
Because two organs are transplanted at the same time, the risks of the surgery are slightly higher than those of transplanting just one organ.
The main risks are rejection of the new organ by the body and infection.
Rejection is when your body's immune system recognizes the new organ as "foreign" and tries to attack it. To prevent this, you will have to take anti-rejection drugs (immunosuppressants) for the rest of your life.
Because these medications weaken your immune system, you are more likely to develop other infections. So you need to be very careful.
If you have the following symptoms, notify your doctor immediately:
- Fever
- Pus or fluid draining from the surgical site
- Severe pain or bruising at the surgical site
- Pain when urinating
In addition, there may be risks such as blood clots and excessive bleeding.
Recovery time and success
After the surgery, you will need to stay in the hospital for at least 10-12 days. In some cases, you may need to stay for up to a month. During this time, the medical team will monitor you closely.
It is essential to take the immunosuppressant medications you are prescribed for the rest of your life on time. It is also very important to go for blood tests and other tests on the days prescribed by your doctor.
How successful is this surgery?
This surgery improves quality of life and lifespan.
- There is an 80% chance of not needing insulin or dialysis for a year.
- There is a 70% chance that both of these treatments will not be needed within the next 5 years.
According to national surveys, the survival rate after this surgery is:
- After a year: 97%
- After 5 years: 92.7%
- After 10 years: 79.1%
This is truly a life-changing experience. It's normal to feel nervous about surgery. But think about the improved quality of life you'll have after surgery. Your medical team is always ready to help you, answer your questions, and make this process as easy as possible. So talk to them about anything that's on your mind.
Take-Home Message
- A combined kidney and pancreas transplant (SPK) is a treatment for both Type 1 diabetes and kidney failure at the same time.
- After this surgery, there is a great chance of being free from insulin injections and dialysis treatments.
- Special medications (immunosuppressants) must be taken for the rest of your life to prevent the body from rejecting the new organ.
- Although there are risks because this is a major surgery, the success rate and improved quality of life are very high.
- If you have any concerns about this, talk openly with your specialist about it.
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