Three types of pancreas transplants are performed at The Transplant Center at the University of Minnesota Medical Center, Fairview, to treat insulin-dependent diabetes. Patients can receive:
Also listed below are the criteria a potential patient must meet in order to be a candidate for a pancreas transplant. Keep in mind, recipient criteria are independent of donor source (living or deceased). Living donor segmental pancreas transplants can be performed in any category, but are primarily performed in SPK category to avoid long waiting times and reduce the need for segmental transplants (kidney followed by pancreas) and depends on having a volunteer with absolutely normal pancreatic endocrine, as well as renal function.
Before determining what type of transplant you are interested in, consider some of the information below. Developing options to meet patients' needs while making optimum use of donated organs is a critical part of our transplant philosophy.
If you would like to find out more information about pancreas transplantation and how you can get one, please contact The Transplant Center at the University of Minnesota Medical Center, Fairview, at 1-800-328-5465.
Pancreas After Kidney Transplant (PAK)
This type of transplant treats chronic renal failure and insulin-dependent diabetes mellitus. It is appropriate for people who are diabetic who:
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have already had a kidney transplant from either a living related donor or a deceased donor. In this case, the transplant patient is already on immunosuppressive medications. It is advantageous to obtain a pancreas transplant to try to stop the harmful effects of diabetes on the patient's body, including the new kidney.
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need a kidney transplant and have the opportunity to receive a kidney from a living donor. Since the waiting time for a deceased donor kidney can be quite long, and some patients die before receiving a life-saving donor organ, it is helpful if they are able to obtain a kidney from a living donor. The living donor could be a friend, family member, coworker, acquaintance, or even someone they don't know. Since the patient who has the opportunity to receive a kidney from a living donor will not have to wait as long as a patient who is waiting for a kidney from a deceased donor, the patient will be in better health at the time of transplant. In this case, the patient can proceed first with a kidney transplant and then wait for a deceased donor pancreas or they may be able to have a simultaneous pancreas kidney transplant.
Indications
- Previous kidney transplant from either living related donor or deceased donor to treat chronic renal failure
- Insulin-dependent diabetes mellitus
Contra Indications
- Uncorrectable coronary artery disease
- Advanced peripheral vascular disease
- Age greater than 60 years
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Pancreas Transplant Alone (PTA)
People with diabetes may decide to have a pancreas transplant alone to free themselves from diabetes management. The patient:
- may not need a kidney but may want to prevent additional complications from diabetes such as diabetic kidney failure
- may suffer frequent hypoglycemic episodes or
- may have serious problems controlling diabetes with insulin injections.
This procedure is appropriate for patients who have labile insulin-dependent diabetes mellitus resulting in impaired quality of life with problems that are more serious than the potential side effects of the immunosuppressive drugs necessary to prevent rejection. For example, hypoglycemic unawareness is best treated by a pancreas transplant.
This treatment would not be appropriate for those with uncorrectable coronary artery disease, advanced peripheral vascular disease, or diabetes adequately controlled by insulin injections.
Indications
- Labile insulin-dependent type 1 diabetes mellitus
- Low quality of life from diabetes per se and problems with diabetes more serious than potential side effects of chronic immunosuppression
- Hypoglycemic unawareness
Contra Indications
- Uncorrectable coronary artery disease
- Advanced peripheral vascular disease
- Age greater than 60 years
- Diabetes adequately controlled by insulin shots or insulin pump
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Simultaneous Pancreas Kidney Transplant (SPK)
If health allows extensive surgery, a person who suffers from diabetes and has developed kidney failure may prefer to become insulin-independent and dialysis-free in one surgery by undergoing a simultaneous pancreas and kidney (SPK) transplant. A successful pancreas transplant can prevent a simultaneously transplanted kidney from recurrent disease.
If extensive surgery is not appropriate, a simultaneous islet and kidney transplant from a deceased donor is a possible option. Candidates for an SPK have chronic renal failure and insulin-dependent diabetes mellitus.
With a segment of pancreas, both organs can come from a living donor. An alternative is to simultaneously transplant the kidney from a living donor and a pancreas from a deceased donor, should one be available on the day a living donor kidney transplant is scheduled, or if the kidney donor is on call to come in when a pancreas is available. The wait for a deceased donor kidney, with or without a pancreas, can be years, so a living donor for the kidney is a big advantage.
Indications
- Chronic renal failure and insulin-dependent diabetes mellitus
Contra Indications
- Uncorrectable coronary artery disease
- Advanced peripheral vascular disease
- Age greater than 60 years
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