Pancreas Transplant for Type 1 Diabetes

Pancreas Transplant Type 1 Diabetes​

A pancreas transplant is an option for individuals with type 1 diabetes, particularly those with severe complications or trouble controlling blood sugar levels. Here's the overview:

What Is a Pancreas Transplant?

A pancreas transplant is an operation in which a healthy donor pancreas from a deceased donor is placed in an individual with type 1 diabetes. The hope is to replace insulin production, so the individual no longer requires insulin injections.

Pancreas Transplantation Eligibility​

Eligibility for pancreas transplantation is established on the basis of medical, surgical, and psychosocial criteria. Here's a summary of the general eligibility criteria:

Medical Eligibility Criteria

You can be listed for a pancreas transplant if you have:

1. Type 1 Diabetes

• Diagnosed with Type 1 Diabetes Mellitus (insulin-dependent).
• Occasionally considered in certain Type 2 Diabetes cases if insulin dependence and other criteria are fulfilled.

2. Severe Diabetes-Related Complications

• Hypoglycemia unawareness (you can't sense when your blood sugar is falling).
• Recurrent severe hypoglycemic episodes.
• Poor control of blood glucose despite best insulin treatment.
• Diabetic nephropathy (kidney disease) necessitating or needing kidney transplant.

3. Proper Body Condition

• Body Mass Index (BMI) usually less than 30–35 (some centers have more stringent criteria).
• No active infections (e.g. HIV, hepatitis if not under good control).
• Satisfactory cardiac function and no severe vascular disease.
• Good overall organ function excluding diabetes-related complications.

Pancreas Transplant Success Rates​

The pancreas transplant survival rates are:

Simultaneous Pancreas-Kidney Transplant​

A Simultaneous Pancreas-Kidney (SPK) Transplant is a double organ transplant in which both a pancreas and a kidney from the same deceased donor are implanted into an individual typically with type 1 diabetes and kidney failure.

Factors Affecting Pancreas Transplant Cost​

The price of a pancreas transplant can differ widely based on a variety of medical, geographic, and institutional variables. The following is a summary of the principal variables that influence the cost:

• Type of Transplant Procedure
• Hospital/Transplant Centre
• Country/Region
• Pre-Transplant Evaluation Costs
• Hospital Stay & Recovery
• Medications & Immunosuppression
• Follow-Up and long-Term Care

Pancreas Transplant Risks​

Pancreas transplants—although frequently life-enhancing—do pose serious risks, particularly due to the nature of the procedure and the drugs required for life after surgery. Following are the pancreas transplant complications:

• Bleeding
• Infection
• Blood Clots
• Leaking or Blockage
• Delayed Healing
• Organ Rejection
• Side Effects of Immunosuppressants
• Pancreas Graft Failure
• Long-Term Health Complications
• Emotional and Psychological Impact

Pancreas Transplant Procedure​

1. Eligibility & Assessment

• Medical testing (labs, heart test, imaging)
• Psychological and lifestyle assessment
• If suitable, you're added to the waiting list for organ transplant

2. Organ Match & Preparing for Surgery

• When a suitable donor pancreas (and kidney, if SPK) is found, you're contacted—usually on short notice
• You're admitted, and tests are conducted to ensure final compatibility

3. Surgical Procedure

• Under general anaesthesia
• Surgery Time: 4–8 hours, depending on if it's pancreas alone or SPK (simultaneous pancreas-kidney)

What Does the Surgery Entail

• Donor pancreas is implanted in the lower right abdomen
• It's not attached to the digestive tract like your natural pancreas—instead, the pancreas is typically attached to the intestines or bladder to allow digestive enzymes to drain
• Your natural pancreas remains in position (it still works to digest)
• If you're receiving a kidney transplant too, it's located in the lower left part of your abdomen

4. Post-Op Care (Hospital Stay: ~1–3 weeks)

• ICU or recovery unit monitoring
• Regular checks on blood sugar levels
• Beginning immunosuppressive medications
• Watch for initial signs of rejection, infection, or surgery complication

Benefits of Pancreas Transplant​

A pancreas transplant provides life-changing advantages, particularly for individuals with type 1 diabetes and related complications. Here's a breakdown of the key advantages:

• Insulin Independence
• Better Blood Sugar Control
• Prevention or Reversal of Diabetic Complications
• Improved Quality of Life
• Increased Life Expectancy
• Fewer Hospital Visits
• Reproductive Health
• Long-Term Cost Savings

Pancreas Transplant Recovery​

Recovery from a pancreas transplant is a disciplined and closely watched process that concentrates on healing, avoiding complications, and safeguarding the new organ. Here's a full breakdown of what to anticipate:

1. Hospital Recovery (1–3 weeks)

Immediately After Surgery

You'll remain in the ICU or transplant unit for close observation.

You'll be given:

• IV fluids, pain medication
• Immunosuppressive drugs to avoid rejection
• Monitoring of blood sugar (insulin may be temporarily needed)

Typical Hospital Stay

• 7–14 days (longer with complications)
• Early mobilization is encouraged to prevent risks such as blood clots or pneumonia
• Catheters and drains are slowly removed

2. Short-Term Recovery (First 3 Months)

Frequent Monitoring

Various follow-up visits a week in the beginning

Tests include:

• Blood glucose and HbA1c
• Creatinine (if kidney transplant as well)
• Drug levels (immunosuppressants)
• Liver function, infection markers

Medication Management

• Begin with high doses of immunosuppressants (e.g., tacrolimus, mycophenolate, steroids)
• Prophylactic antibiotics/antivirals
• Tapering slowly under medical supervision

Lifestyle Changes

• Healthy eating (low in sugar, salt, fat)
• Shun alcohol, smoking, and raw/undercooked food
• Practice good hygiene to avoid the risk of infection

3. Mid to Long-Term Recovery (3+ Months)

What Gets Better With Time

• Independence from insulin (most successful patients no longer need insulin)
• Improved stability in medication dosages
• Energy and appetite come back over time
• Decreased necessity for frequent lab and visits

Ongoing Monitoring

Monthly appointments, then every few months/a year as directed

Lifelong lab tests for:

• Functioning of pancreas
• Presence of rejection or infection
• Side effects of prescription drugs (e.g., liver, kidney, cholesterol)

Pancreas Transplant Criteria​

These are the usual requirements for qualifications for a pancreas transplant, particularly for individuals with type 1 diabetes and associated complications:

• Type of Diabetes
• Kidney Function
• Poor Diabetes Control despite Best Treatment
• Age and General Health
• No Active Conditions That Could Complicate Surgery
• Ability to Adhere to Post-Transplant Care
• Psychological Readiness

Pancreas Transplant Centers

• Fortis Memorial Research Institute, Gurgaon
• Medanta-The Medicity, Gurgaon
• Apollo Hospital, Delhi