Are you suffering from Type 1 Diabetes , a severe form of diabetes that is difficult to control? Taking insulin all day, controlling your diet, and constantly checking your blood sugar levels can be tiring at times , right? If so, what we are going to talk about can bring new hope to your life. Today, we will talk about pancreas transplant .
Simply put, what is a pancreas transplant?
A pancreas transplant is a surgical procedure in which a healthy pancreas from a deceased donor is transplanted into the body to replace a diseased pancreas.
The pancreas is an organ in our body located behind the stomach. Its main function is to produce a hormone called insulin . This insulin helps our body convert the sugar (glucose) in the food we eat into energy. However, in people with Type 1 Diabetes , the pancreas produces very little or no insulin. That is why they have to inject insulin from outside.
Who really needs this surgery?
This surgery is mainly done for people with uncontrolled, long-term, severe type 1 diabetes. Sometimes insulin injections alone are not enough to control diabetes . As blood sugar levels remain high without control, other organs in the body begin to be damaged.
One of the most serious complications of this type is kidney disease . Many people who are eligible for a pancreas transplant also have kidney failure. Therefore, a pancreas transplant is often performed at the same time as a kidney transplant .
After a healthy pancreas is transplanted, a person with diabetes begins to produce insulin on their own. This is called insulin independence.
Why is this surgery so important?
The closest cure for type 1 diabetes is a pancreas transplant. This surgery can help you live a longer, happier life. After this surgery, you may experience:
- Checking blood sugar levels daily.
- Injecting insulin throughout the day.
- Strict dietary restrictions.
- Risk of serious complications from diabetes.
What should I do before the surgery?
If your doctor thinks you are a good candidate for this surgery, they will refer you for a series of tests. Specialists will also talk to you to make sure you have a good understanding of the surgery and its risks.
| Test type | Description |
|---|---|
| Blood and urine tests | Make sure your body is healthy enough to withstand surgery. |
| Physical examination and medical history | Gain insight into your overall health status. |
| Immunological studies | These tests will help you choose the donor that best suits you. |
| Imaging tests | Scans such as ultrasound and MRI provide the information needed to plan the surgery. |
| Psychological evaluation | Make sure you have a good understanding of the surgery, its risks, and the lifelong precautions you will need to follow. |
If all of this is done and you are deemed eligible, your name will be placed on a national waiting list. You may have to wait months or even years for a matching pancreas to become available.
What do you do when you're in line?
It is very important that you stay as healthy as possible during this time.
- Attend every clinic you are assigned to.
- Avoid smoking completely.
- If possible, exercise as directed by your doctor.
- Limit alcohol.
- If there is any change in your health, inform the transplant team immediately.
- Take the prescribed medication exactly on time.
What if I have to go for surgery? Here's how to prepare.
The surgery will need to be performed as soon as a suitable pancreas is available, so you need to be prepared at all times.
- Make sure the transplant team can contact you at any time.
- Prepare a bag with the necessary items, such as clothes, for the hospital.
- Let your family, friends, and workplace know about this in advance so they can be prepared if you have to leave suddenly.
How is the surgery done?
A pancreas transplant operation usually takes about 3-5 hours. It can take longer if a kidney is also being transplanted. You will be under general anesthesia, so you will not feel anything. The surgeon will follow these steps:
1. An incision will be made in your abdomen, starting below your breastbone and extending down to your groin.
2. The pancreas taken from the donor is implanted in the right side of the abdomen.
3. It connects to nearby blood vessels and the small intestine.
4. Most importantly, your old pancreas is not removed, as it continues to produce digestive juices.
5. Finally, the incision is closed with stitches.
What happens after the surgery?
If the surgery is successful, the new transplanted pancreas will start producing insulin almost immediately. After the surgery, you will be transferred to a special unit and closely monitored for complications and organ rejection.
You will have tubes connected to give you saline, nutritional fluids, and painkillers. You will also have separate tubes to drain urine and fluid from the surgical site. If there are no complications, you will be able to go home in about two to three weeks.
What are the risks and complications of this surgery?
This is a complex surgery and there may be some risks and complications.
| Risk/Complication | Description |
|---|---|
| Blood clots | There is a risk of blood clots forming in the blood vessels after surgery. |
| Infection | Infections can occur in the surgical wound or within the body. |
| Organ rejection | That means your body recognizes this newly transplanted pancreas as a 'foreign object' and tries to attack it. |
| Pancreatitis | Swelling or inflammation of the transplanted pancreas. |
How long will it take to return to normal life?
It can take about six months to fully recover. Typically,
- The stitches will be cut in about three weeks.
- I have to see the doctor regularly for several months and get tests done.
- You can start light exercise after about six weeks. Lifting weights is not recommended at all.
- I will have to take a few months off from work.
Your doctor will give you specific instructions.
Things to know about medication and the future
If there are no complications, the outlook after surgery is usually very good. You can live a healthy life for years, even decades.
Most importantly, after surgery, you will need to take immunosuppressants for the rest of your life. These medications prevent your body from rejecting the new organ. Although these medications can cause side effects, never stop taking them without talking to your doctor.
Most people will not need insulin after surgery. However, some people may need it in small amounts. However, it is much easier to control low blood glucose levels after surgery.
What are the symptoms that require immediate medical attention?
If you develop signs of infection or organ rejection, you should seek medical advice immediately. In such cases, go to the Emergency Department (ETU) of the nearest hospital.
| Fever (over 37 Celsius / 100 Fahrenheit) | Body aches, headaches |
| Feeling cold, shivering | Dizziness |
| Less urine output than normal | Nausea or vomiting |
| Pain or stiffness at the site of the pancreas transplant | Body swelling or sudden weight gain |
Take-Home Message
- Pancreas transplantation is a major surgery for severe type 1 diabetes.
- This allows you to live a life free from insulin injections, constant dieting, and diabetes complications.
- This is a complex surgery with a lengthy evaluation process and waiting time.
- After surgery, it is mandatory to take lifelong medications (immunosuppressants) to prevent the body from rejecting the transplanted organ.
- If you notice any signs of infection or organ rejection, such as fever, pain, or swelling, notify your doctor immediately.
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