What is pancreas transplant?

A pancreas transplant is surgery to give you a healthy pancreas. It may be combined with a kidney transplant if you also have kidney failure. The new organs come from a person (donor) who is deceased.

Before the transplant, you'll have many tests. These include tests to see how well the donor pancreas matches your tissue type and blood type.

During surgery, the doctor makes a cut (incision) in the middle of your belly. The donor pancreas is connected to your small intestine or your bladder so that digestive juices from the pancreas can drain. A small section of the donor's small intestine (duodenum) is also transplanted for that purpose. The doctor then connects the blood vessels of the donor organ to your blood vessels. Your own pancreas may still help with digestion. It will be left in your body unless it's causing problems. The doctor closes the incision with stitches or staples.

Activity

• Be active. It can help prevent problems and help you recover. Walking is a good option for many.
• For 4 to 6 weeks, or until your doctor says it's okay, avoid exercises that strain your belly muscles and activities that make you work hard, such as bicycle riding, jogging, weight lifting, or aerobic exercise.
• For 4 to 6 weeks, or until your doctor says it's okay, avoid lifting anything that would make you strain. This may include heavy grocery bags, a heavy briefcase or backpack, or a child.
• Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
• Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
• Ask your doctor when you can drive again.
• Many people are able to return to work about 1 to 2 months after surgery. It depends on the type of work you do and how you feel.
• You may take showers. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when it is okay for you to have sex.

Diet

• Follow your doctor's instructions about what to eat after your surgery. You may need to follow a special diet for your pancreas or kidney or for other health problems.
• Drink plenty of fluids (unless your doctor tells you not to).
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.
• Don't drink alcohol, unless your doctor tells you that you can. Alcohol can cause problems with some of the medicines used to prevent organ rejection.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take your anti-rejection medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Don't take any over-the-counter medicines unless your doctor says it's okay.

Incision care

• You may have a dressing over the cut (incision). A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
• If you have strips of tape on the cut (incision) the doctor made, leave the tape on until it falls off.
• Gently wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.

Most people can have a good quality of life after their transplant. For example, people who had diabetes before their transplant may no longer need to take insulin, and their A1c levels are much improved. With better control of blood sugar, there's less danger of damage to the new organ.

The success of a pancreas transplant may depend on:

• Your overall health. After the transplant, it's important to keep a healthy lifestyle. This includes eating healthy foods and being active. Don't smoke or drink alcohol.
• Whether you take your medicines as prescribed. Anti-rejection medicines must be taken every day from now on.
• Finding and treating organ rejection early. This makes it more likely that your transplanted pancreas will stay healthy. That's why it's important to go to follow-up appointments and get tests.

Like any surgery, a pancreas transplant has some risks. Risks include:

• Organ rejection. Your body tries to destroy the transplanted organ by rejecting it. It happens because the donor organ doesn't match your own tissue exactly.
• Problems such as bleeding during and after the surgery.
• Infection. The medicines you'll need to take to help your body accept the new pancreas can also make it harder for your body to fight infection.
• Certain cancers, such as skin cancer. This risk increases because anti-rejection medicines can also prevent the body from attacking cancer cells.

After a pancreas transplant, you will be cared for in the intensive care unit (ICU) for a couple of days. You will likely need to stay in the hospital for 1 to 2 weeks after the transplant. It may take 2 to 4 months for your energy to return.

Your pancreas should start working right away.

After the transplant, you will take medicine to keep your body from rejecting the new pancreas. You will need to take anti-rejection medicines every day for the rest of your life.

Getting support

Having good support is important throughout the process of getting a transplant. Waiting for your transplant can be hard emotionally. After your surgery, you may have concerns about your health and the new organ or organs you received. You'll also have a lot to manage, like taking new medicines and going to follow-up visits.

Getting support from others, such as friends and family, can help during this time. A counselor can help you learn to cope with stress and other emotions before and after your surgery.

Many people who have an organ transplant feel anxious or depressed. Talk to your doctor if you think you may be depressed. Depression can be treated with medicines and counseling.

A pancreas transplant is surgery to give you a healthy pancreas. The new organ comes from a person who is deceased. Your surgery may have been combined with a kidney transplant.

Your new pancreas should start working right away. It will make the insulin your body needs. So if you had diabetes before your transplant, you may not have to take insulin to treat your diabetes anymore. Even if you still need to inject insulin, controlling your blood sugars may be much easier. Your new pancreas will also make enzymes, or proteins, to help your body digest food.

Your belly will be sore for the first few weeks after surgery. You also may have some numbness around the cut (incision) the doctor made. You may feel tired while you are healing. It may take up to 2 to 4 months for your energy to return.

After surgery, you may have a tube coming out of your belly near the incision to drain fluid. The tube may be removed in the hospital or after you go home.

After you leave the hospital, your doctor will watch you closely for several weeks or months. You'll need to stay close to the transplant center or hospital and go to all your follow-up appointments.

After the transplant, you will take medicine to keep your body from rejecting the new pancreas. You will need to take anti-rejection medicine every day for the rest of your life. These medicines have side effects. One side effect is that your body may be less able to fight infections. It's important to take steps to avoid infections. Be careful in public spaces and crowds of people. Stay away from anyone who might have an infection or an illness such as a cold or the flu. Other side effects include high blood pressure, nausea, diarrhea, and weight gain.

Having an organ transplant can bring up many emotions. You may feel grateful and happy. But you also may feel guilty or depressed. Seek out family, friends, and counselors for support. If you think you are depressed, ask your doctor for help. Treatment can help you feel better.

You may need a transplant if your pancreas doesn't work as it should. This is usually because of type 1 diabetes. But it may also be due to chronic pancreatitis or an injury to the pancreas.