Pancreas transplantation

Overview

Pancreas transplantation continues to be studied at many centers in the U.S. and around the world, and it is the standard treatment in certain situations.

When successful, a pancreas transplant cures diabetes, or at least reduces the number of severe episodes of low and high blood glucose. Blood sugar levels become normal because the new pancreas produces insulin. However, as with most types of solid organ transplantation, a number of complications may occur. The most common complications include rejection of the new organ, infection, and adverse effects from the antirejection medications that must be taken indefinitely after transplantation.

In type 1 diabetes, the pancreas produces too little insulin or none at all. Thus, replacing a nonfunctioning pancreas with a healthy transplanted pancreas would seem to be a cure for type 1 diabetes.

In the 1960s, pancreas transplantation was first attempted. However it was not until the improvement of surgical techniques and the introduction of new anti-rejection medications years later that pancreas transplantation became a realistic potential treatment for type 1 diabetes. 

Types

There are three types of pancreas transplants:

  • Simultaneous pancreas and kidney transplant (SPK) - Because most people with type 1 diabetes who meet the criteria for pancreas transplantation also have some degree of kidney disease, simultaneous transplantation of both a pancreas and a kidney is often performed. The best success rates have been achieved with this type of procedure.
  • Pancreas after kidney transplant (PAK) - In this procedure, a pancreas is transplanted into a person who has already received a kidney transplant. This procedure generally has a success rate near that of SPK procedures.
  • Pancreas transplant alone (PTA) - In this procedure, only the pancreas is transplanted. This type of procedure is done less often, and generally has a lower success rate than the other procedure types.

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