Pancreas and Simultaneous Pancreas Kidney Transplantation
At our center, for select patients with renal failure from Type I diabetes under the age of 55, it is possible to consider the possibility of a pancreas transplant.
The majority of pancreas transplant patients undergo both a kidney and pancreas transplant at the same time (simultaneous pancreas and kidney transplant, SPK), once they have progressed to end stage renal disease. In these cases both organs come from the same deceased donor.
Alternatively, candidates who already have a functioning transplant or those with a possible living kidney donor may be candidates for a pancreas after kidney transplant (PKA) with a deceased donor pancreas transplant. A very few Type I diabetics with excellent kidney function who suffer from severe life-threatening episodes of hypoglycemic unawareness (low blood sugars) may be considered for a pancreas transplant alone (PTA).
There are both advantages and disadvantages to considering adding the option of a pancreas transplant if you are a Type I diabetic. These will be discussed in detail with you by one of our team physicians.
Successful pancreas transplant can result in you no longer requiring insulin, with the long-term goals that the complications of your diabetes (problems with your nerves and blood vessels that lead to issues with wound healing, vision, digestion, peripheral vascular disease, neuropathy, limb loss, stroke, and cardio vascular disease) may stabilize or in some cases reverse.
The Transplant Hospital Stay: Pancreas
The following timeline is representative of the typical pancreas transplant recipient; no patient will have exactly the same experience.
Day of Surgery
- You will be admitted directly to the Transplant Unit.
- Blood samples will be obtained.
- A chest x-ray and EKG may be obtained.
- How quickly you proceed to surgery will be determined by many factors including the receipt of the donor organ(s), the time for crossmatch testing, and your need for dialysis or additional testing before surgery.
- The surgery time is approximately six hours for a simultaneous kidney and pancreas transplant and may vary by individual case.
- After the surgery, you will spend one night in the surgical intensive care unit.
- You will receive IV fluids to prevent you from becoming dehydrated and through which you may get some medications.
- You will have a Foley catheter that was placed during surgery in your bladder to drain your urine.
- You will have a nasogastric tube that was placed during surgery to prevent your stomach from becoming distended the first several days after surgery.
- You will be assisted in taking your first walk after surgery, and will be expected to increase your amount of activity every day to prevent complications such as pneumonia and blood clots.
- You will be encouraged to cough and deep breathe to prevent pneumonia.
- Your diet will be advanced as your bowels return to normal function, usually post-operative day four to five, and your Foley and nasogastric tubes will be removed.
- A transplant pharmacist will educate you and your family about your new medications.
- A transplant coordinator nurse will meet with you and your family to arrange for local laboratory blood work.
- Most patients are ready for discharge seven to ten days after transplant.
- You will have your first follow-up appointment at the Organ Transplant Clinic approximately two weeks after discharge. You will be given the date and time of this appointment before you are discharged.
- At a post-operative visit, you will also have an appointment with urology for removal of the stent (small plastic tube) that was placed between your transplant kidney and bladder during the transplant surgery.
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