Pancreas Transplant

With advancements in medicine, organs are being donated and transplanted daily to help improve the quality of life of patients. One of these organs is the Pancreas. For a donation to occur, there either needs to be a situation where a transplant needs to be done, or an organ bank is available to store the donated organ. Several conditions lead to a pancreas transplant. However, it is important for you to have an overview of the pancreas and some of its functions for a better understanding of the procedure.

The Pancreas and its Function

The pancreas is an organ found in the upper abdomen, lying behind the stomach, close in proximity to the small intestine. Unlike other organs, the pancreas performs as a dual-gland having both exocrine and endocrine functions.

Exocrine Functions

The pancreas secretes a digestive juice known as the pancreatic juice. This juice contains enzymes that help in the further digestion of food particles before sending them to the small intestine for absorption into the blood stream. The enzymes in the pancreatic juice help to further break down carbohydrates, lipids, proteins and nucleic acids in food.

Endocrine Functions

Being also an endocrine gland, the pancreas is a hormone-producer which secretes the hormones called insulin and glucagon. These hormones go into the bloodstream to help regulate the level of the blood glucose. The absence of these hormones can lead to several complications in the body system.

The body suffers several conditions due to issues faced by the pancreas. Some of these problems can be detected and treated with regular medications. However, chronic cases might call for a pancreas transplant.

These issues, when prolonged, can become complicated and lead to a decrease in the quality of life of a patient and subsequently death. It is important to know some of these problems, for you to have a better background before studying the pancreas implant procedure or considering pancreas donation.

Pancreatitis

This is simply an inflammation of the pancreas. Pancreatitis can either be acute or chronic, and several vices cause this inflammation. Some of the causes of pancreatitis are; alcoholism, smoking of cigarettes, gallstones, infection, family history, hypercalcemia, hyperparathyroidism, cystic fibrosis, increased triglyceride levels, pancreatic cancer and so on. Some of these factors that lead to pancreatitis are genetic. However, some are self-imposed and can lead to many problems in the body system.

Some of the Problems Related to Pancreatitis:

Acute Pancreatitis

Pancreatitis in its early stages leaves the pancreas vulnerable to several bacteria which can lead to an infection. A pseudocyst is another issue that can occur. It causes cyst-like pockets in your pancreas to collect and store fluid. A large pseudocyst can rupture and cause further infection. To treat these diseases, the most effective method is performing surgery to remove the infected part of the pancreas.

Also, acute pancreatitis can lead to kidney failure. Dialysis can be used to treat severe kidney failure. However, the dialysis procedure alone might not suffice. Chemical changes brought about by acute pancreatitis can affect the lung function leading to breathing problems in patients. These breathing problems will, in turn, reduce the level of oxygen in the blood and cause other problem in other organs in the body.

Chronic Pancreatitis

Both acute and chronic pancreatitis can lead to malnutrition since they cause the pancreas to produce little amounts of digestive enzymes. Long standing inflammation can also lead to Pancreatic cancer, and this can call for the organ transplant. However, one of the major reasons for a pancreas transplant is Diabetes.

Diabetes

Pancreatitis leads to the damage of the pancreatic islets (islets of Langerhans), and these islets produce insulin – a hormone that regulates the blood sugar levels. Due to the shortage of insulin, diabetes occurs. Diabetes is a disease that affects the way the body uses blood sugar, and it is of two types.

Type 1 Diabetes: this is a form of diabetes that occurs when the body does not produce insulin, and this is the cause of about 10% of diabetes cases.

Type 2 Diabetes: this amounts for the remaining the 90% of diabetes cases in which, the body does not produce enough insulin for proper function.

Although both types of diabetes can lead to life-threating situations, type 2 diabetes can be treated with insulin shots to increase insulin levels in the body and prolong patient survival. However, type 1 diabetes is more complicated and may require a pancreas transplant.

Why are Pancreatic Transplants Performed?

Type 1 diabetes patients are not able to produce insulin on their own, and the pancreas transplant will correct this flaw. With a pancreatic transplant, patients with type 1 diabetes will now have the chance to produce insulin with the new pancreas and regulate their blood sugar.

These transplants are not always easily considered because of their high risks and professionals prefer to depend on insulin injections. However, several conditions could occur that will call for the transplant. Some of these conditions are;

Kidney Disease

If a patient has kidney disease, it is possible that the pancreas may have been affected in several ways. Although dialysis can help regulate the kidney, when there is a cause for a kidney transplant, a pancreas transplant could be done as well.

Hypoglycemia

The patient is also at risk of suffering episodes which occur due to dangerously low blood sugar. Most times, insulin injections might not be enough to control these episodes, hence, the need for a pancreas transplant.

There is a limit to how much insulin shots can help a patient with type 1 diabetes. If the shots are not enough to support the patient’s body system, several things can happen; Amputations, Disease of the arteries, Blindness, Heart disease, Kidney damage, Nerve damage, Stroke may occur. Therefore, the importance of pancreas donations and implants cannot go overlooked.

There are some cases in which pancreas transplant cannot be performed even when the patient needs one. Pancreas transplant surgery cannot be performed when a patient has the following;

  • A history of cancer
  • HIV
  • Infections such as hepatitis, which are active
  • Lung disease
  • Obesity
  • Infections of the blood vessels in the leg and neck
  • Severe heart diseases (like heart failure, severe coronary artery disease, or poorly controlled angina)
  • Smoking, alcohol or drug abuse, or other lifestyle habits that can damage the new organ.

Therefore, several tests must be performed on the patient before the transplant surgery is performed. These tests will determine if the surgery can be performed or not; patients also must make sure to take care of themselves before the surgery.

What to do Before the Pancreas Transplant Surgery

When prepping for a pancreas transplant surgery, there are several things you must do, and they are;

  • Listen to your doctor; these professionals know what is best for you, and they recommend the best transplant centers. You must sit with them to view several centers and agree on the best and most convenient one for your situation.
  • Tests; ensure you take all the necessary blood examinations, skin test, heart test and cancer detection tests before the surgery. These tests are necessary, and they determine how responsive you would be to a new pancreas. If after these tests the transplant center considers you eligible for a pancreas transplant, you would be put on the National waiting list.

While waiting for your surgery, you must follow these important steps;

  • Be sure to follow the diet which your transplant team will recommend for you.
  • Try not to smoke cigarettes or drink alcoholic beverages.
  • A weight range will be recommended, and it is advised to follow it and perform recommended exercises.
  • Do not miss any appointment with your regular doctor or transplant team.
  • Fill the transplant application form properly, so the team can contact you when there is an organ available.
  • Get everything you will need before you go to the hospital for your surgery.

What Happens During the Pancreas Transplant Surgery?

Transplant performed on the pancreas can either be partial or full. In a case where only the pancreatic islets are damages, the pancreatic cell containing these islets of Langerhans alone can be transplanted. This is known as the Pancreatic Islet Transplantation.

This form of transplant can either be an allotransplantation or an autotransplantation. allotransplantation is performed after the deceased pancreas has been purified. The new pancreatic cell is not introduced to the original pancreas. This procedure is still experimental. However, the autotransplantation is performed after a complete pancreatectomy (total removal of the pancreas).

The main study which is the Pancreas Transplantation surgery has a different procedure.

When another patient is declared brain dead, the pancreas is harvested while that patient is still on life support. The healthy pancreas can be transferred in a cooling solution which preserves it for up to 20 hours. Tests are performed to make sure the donor pancreas is compatible with your body system. Immediately a donor pancreas is available for implantation; you will be called in for the surgery.

At the beginning of the surgery, you will be placed on general anesthetic, and the surgery will be performed when you are completely under the influence of the anesthetic.

Once you are asleep, an incision (cut) is made along your abdomen (tummy) to expose the internal organs. Your affected pancreas is not removed during the surgery. The donor pancreas (alongside the donor kidney in some cases) is then attached by its blood vessels to the blood vessels found in the lower abdomen.

Immediately the donor pancreas is in place; it begins to secrete insulin for your body system, supporting your original pancreas which now takes up the function of secreting digestive juice which breaks down food particles.

The pancreas implant surgery takes about 3 hours. However, if the surgery is performed alongside a kidney implantation it will be prolonged to about 6 hours. Only patients with diabetes-related kidney disease will require a kidney transplant. Therefore, both organs must be harvested from the donor and tested at the same time.

Recovering After the Pancreas Implantation

After the surgery, you will have to remain in the hospital for about 3-7 days depending on how you respond to the surgery. However, it is advised to remain in the hospital for two weeks to a month for close observation and tests.

The transplant team will draft out a new daily plan for you. There are some activities you cannot perform for some time after the surgery, these experts will advise you on these activities and when you can start them. You will also have to attend follow up check-ups with the team that performed the transplant.

Immunosuppressants will be prescribed to you after the surgery, and you will have to depend on them for the rest of your life. These are drugs that help your body accept the new pancreas. If your body detects the new organ without these drugs, it will be considered a foreign element and your body system will attack accordingly. This concept is known as Rejection.

Risk of Pancreas transplant surgery

During the surgery, some patients react to the general anesthetic, and the following could occur;

  • Several reactions to medicine.
  • Breathing issues (hypoventilation).
  • Severe bleeding
  • Blood clotting
  • Infections

After the surgery, many things could also occur which could lead to complications. These problems are;

  • Inflammation of the new and original pancreas (pancreatitis).
  • Clotting (thrombosis) of the arteries or veins of the new pancreas.
  • Development of certain cancers after a few years.
  • Leakage of fluid from the new pancreas where it attaches to the intestine or bladder.
  • Rejection of the new pancreas.

Prognosis

Generally, after the surgery, the body begins to receive the required insulin level for regulating blood sugar. The need for insulin injections, daily blood sugar test, and diabetes diet will be reduced drastically. There is evidence that the complications of diabetes, such as diabetic retinopathy, may not get worse and may even improve after a pancreas-kidney transplant.

The outlook and general statistics of people surviving and their survival rate after the pancreas implantation surgery is quite impressive.

It has been seen from research that most people live for several years after the surgery, sometimes for decades. About 97% live for at least a year after the transplant, and over 90% live for five (5) or more years.

Patients who experienced surgery with just a pancreas implant, have about 65% donor pancreases still working after a year and over 45% donor pancreases still functional after five (5) years or more.

On the other hand, patients who had a kidney transplant along with the pancreas implantation, have about 85% of the donor pancreases still work after a year or more. About 75% of these patients have their donor pancreases still working after five (5) years and sometimes even more.

After the donor pancreas stops working, another surgery must be performed to remove the non-functional pancreas. This will place the patient on the waiting list for a subsequent pancreas implant to help sustain and improve the quality of life.

Pancreas Donation

Over the years, several organization and centers have come to life. These organizations specialize in registering people for organ implantations and focus on finding suitable donors around the world.

A lot of people would love to donate their organs after they die and might not know how to go about it. If you are interested in being a donor when you die, it is advised to contact one of these organizations to know about the procedure.

The procedure these days is not as cumbersome as most people think. You can register to be a donor on the websites of this organization to make your donation with ease. You can specify what organ you would love to donate and you can also opt out of your donation.

These treatment plans have been saving lives for years, and it will continue that way. As these transplants cannot be made without a donor organ, medical association advise you to save a life today or in the future by donating an organ.