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Pancreas Transplantation

by Martin Hertl, MD, PhD, Paul S. Russell, MD

Pancreas transplantation is done for people who have diabetes if their pancreas cannot make any insulin . More than 80% of people who have diabetes and who receive a pancreas transplant have normal blood sugar levels afterward and no longer need insulin , but they trade this benefit for the need to take immunosuppressants, with the risk of infections and other side effects. Because injectable insulin is a safe and reasonably effective treatment for diabetes, freedom from insulin is not considered a sufficient reason for pancreas transplantation. Thus, this procedure is usually done only if people with diabetes also have kidney failure or if they cannot keep their blood sugar levels within an acceptable range, particularly if they do not sense when their blood sugar levels become too low. (Occasionally, when blood sugar levels remain too low for too long, organs, including the brain, are permanently damaged.). Overall, more than 90% of people who receive a pancreas transplant receive a kidney transplant at the same time. Kidney transplantation requires abdominal surgery and the use of immunosuppressants afterward, so transplanting a pancreas at the same time adds few risks.

Pancreas transplantation may be beneficial for people who are taking insulin but still have high blood sugar levels and whose blood sugar levels become dangerously low after taking insulin.

Pancreas transplantation is a major operation, requiring a long incision in the abdomen and a general anesthetic. The recipient’s pancreas is not removed. Typically, the operation takes about 3 hours and the hospital stay is 1 to 3 weeks.