Are Pancreas Transplants Successful?

Reviewed on 11/19/2020
As per research, pancreas transplants are considered successful.
As per research, pancreas transplants are considered successful.

As per research, pancreas transplants are considered successful. Based on 2004-2015 data, patient survival rates for different subtypes of pancreatic transplant ranged from 96 to 99% at 1 year, 89 to 91% at 5 years, and 70 to 80% at 10 years postoperatively. The majority of deaths in the first three months after the transplant were due to cardiovascular or cerebrovascular disease. Five-year pancreas graft survival for different types of pancreatic transplants was approximately between 53 and 73%.

Occasionally, the transplant isn’t successful, and the pancreas may need to be removed. This happens to 1 in 10 (10%) of patients in the first year. Even though the concept of pancreas transplantation had been around for decades, it was only in the late 1960s that doctors began to see successful outcomes from combined kidney and pancreas transplants.

On the downside, patients who received a combined pancreas and kidney transplants did run a greater risk of death during or immediately after surgery than those who underwent kidney transplants alone. This led critics of pancreas transplantation to characterize the procedure as experimental and even dangerous. Gradually, however, the success rate of pancreas transplantation has improved. 

As per Organ Procurement and Transplantation Network, Pancreas and Kidney Transplant survival rates, the likelihood of a successful simultaneous pancreas-kidney transplant after five years of transplant stand at about 73%. The success rate of a pancreas-after-kidney transplant after five years post-transplant is about 65% and pancreas-only transplant after five years is about 53%. 

Why is pancreas transplant required?

The goals of pancreas transplantation include:

Pancreas transplantation is most often performed with simultaneous kidney transplantation in selected patients with type I diabetes and end-stage kidney disease, who will already be required to take immunosuppressive therapy for the kidney graft. The pancreas requires some surgical reconstruction, using donor blood vessels, to enable it to be then transplanted. Three joins are performed on two arteries and a vein, prior to commencing the recipient surgery. This so-called “back table” surgery is crucial and takes one and a half to two hours in duration. The recipient surgery is often performed using a lower midline incision, with the pancreas joined to the artery and vein on the right side of the pelvis and then the kidney joined to the vessels on the left.

The pancreas is located in the upper area of the abdomen and is an important part of your digestive system. Some of the functions of your pancreas include:

Types of pancreas transplantation include:

  • Pancreas-Alone Transplant: This procedure is also known as pancreatic islet transplantation. Islets are important cells of the pancreas. This procedure is performed on patients who have type I diabetes with severe symptoms and poor-quality life.
  • Simultaneous pancreas-kidney transplant (SPK): This procedure involves transplanting the pancreas and kidney simultaneously.
  • Pancreas-after-kidney transplant: This is done after kidney transplantation; the necessity of the pancreas will be determined by the doctor depending on the patients’ health.
  • Simultaneous Cadaveric Donor Pancreas and Liver Donor kidney: This procedure is beneficial because the odds of delayed graft function are lower than SPK, and it has reduced the waiting period, resulting in better results. During the procedure, the recipient’s infected pancreas is left as it is, and a healthy pancreas from the donor is placed in the front part of the abdomen and attached to the blood vessels in the lower abdomen. The donor’s duodenum is connected to either the recipient’s intestine or bladder so that the pancreas functions.

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What is the recovery period after pancreas transplant?

Patients may recover within three to six months after the procedure. Immediately after surgery, patients will spend 24-48 hours in intensive care. Patients may be able to get out of bed the day after surgery. Hospital recovery is usually between 7 and 10 days. In some cases, the stay can last up to weeks if there are complications associated with the transplant. After the transplant, patients will immediately start taking a host of medications to keep the new organ healthy. These medicines will keep your immunity low so that your body does not reject the new pancreas. Over time, the doses of the medicines will drop, but patients must take them throughout the life of your transplant.

What are the risks involved in pancreas transplant?

Pancreas transplantation is major surgery, and risks should be noted prior to proceeding with the surgery. Risks include:

The side effects of immunosuppressive drugs are as follows:

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References
Pancreas and islet transplantation in diabetes mellitus: (https://www.uptodate.com/contents/pancreas-and-islet-transplantation-in-diabetes-mellitus)

Pancreas transplant: (https://medlineplus.gov/ency/article/003007.htm)

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