Pancreas Transplant Surgery and Post-Transplant Care
Pancreas transplant surgery is quite complex, even more so than a kidney transplant. But, despite this complexity, the long-term survival rate for patients who have had pancreas transplant surgery during the past 25 years is quite good. Not only do most of these patients survive well beyond their transplant, but they also are able to eat a regular diet without the aid of insulin injections.
Surgery will be performed while the patient is asleep under general anesthesia, and a ventilator will take care of the patient’s breathing during this time. The surgeon will place the donor pancreas in the recipient through an 8-inch incision in the abdomen. The new pancreas also will come with a portion of small intestine, which serves to drain digestive enzymes from the pancreas. This portion of the donor’s intestine will be connected to either the recipient’s small intestine or urinary bladder (our surgical preference) to provide drainage. The surgeon will then close the site, mostly with sutures that do not need to be removed. The recipient’s original pancreas will not be removed during the surgery.
A pancreas transplant alone (PTA) or a pancreas after kidney transplant (PAK) takes about three-five hours, while a simultaneous pancreas-kidney transplant (SPK) requires about five-eight hours.
After Surgery - In the Hospital
Immediately after surgery, the pancreas transplant recipient, in most cases, will be transferred to the intensive care unit (ICU) for a brief period of observation. The patient will remain in the hospital for a total of about five to seven days following surgery.
After the Hospital
Pancreatic function will need to be monitored closely for the first several months after a patient leaves the hospital. The frequency of a patient's visits to the clinic and the need for blood work depends on individual’s progress and will lessen as they recover. Risk for rejection and infection decreases with time, but is never completely gone. Follow-up visits will be more flexible when the wound is healed, pancreas function is normal, and medication dose is adequate. At this time, blood tests may be done at a location closer to the patient's home. Follow-up care will be managed by the local doctor and lab facility.
A patient's condition will continue to be monitored throughout their lifetime. Patients can either be seen by our transplant specialist or closer to their home by an experienced nephrologist or endocrinologist, in collaboration with our team.
Exercise and diet after transplant are very important factors in feeling healthy again. Post-transplant patients are encouraged to resume or begin a regular exercise plan when they leave the hospital, and the regimen should be done under a doctor’s guidance.