Pancreas Transplant Procedure
The transplant process begins with
admission when a donor pancreas or pancreas-kidney becomes available,
and continues through transplant surgery.
When a deceased donor pancreas or
pancreas-kidney becomes available the patient will be notified and will
be admitted to the hospital. The patient will meet again with a
nephrologist and a transplant surgeon to answer any questions, and a
consent form will be signed to authorize the procedure.
If the patient has been on dialysis, he
or she may require a session of dialysis prior to the transplant
procedure. The Transplant Center provides both hemodialysis and
peritoneal dialysis so it is unnecessary for the recipient to bring
his/her peritoneal dialysis supplies.
Transplant Procedure: Simultaneous Pancreas-Kidney Transplant
Once the organs are prepared for
transplantation the patient will be taken to the operating room.
Pancreas-kidney transplantation is performed in about 4 to 6 hours under
general anesthesia. Our team of specialized transplant
anesthesiologists will ensure that our patients receive the best
available care while the transplants are being performed.
Once the patient is asleep the surgeon
will make a vertical incision in the midline of the abdomen. The surgeon
will identify the pairs of blood vessels that bring blood to and from
the leg on each side, and these blood vessels will be used to bring
blood into and out of the donor organs. In general, the pancreas is
implanted on the right side and the kidney is implanted on the left
Digestive Fluid Drainage
After blood flow is restored to the
pancreas, the pancreas is connected to a segment of the patient's
intestine to allow drainage of the digestive fluids produced by the
pancreas. Some transplant centers drain these fluids into the patient's
bladder, but this type of pancreas drainage is not performed at our
Donor Ureter Implantation
After blood flow is restored to the
kidney the ureter (urine tube) from the donor kidney will be implanted
directly in the bladder so that the urine will be passed normally. A
stent is placed in the donor ureter as it goes into the recipient's
bladder, and this stent will be removed in an urologist's office 2-3
weeks after the transplant.
The native kidneys will not be removed
unless there is a specific reason to remove them, and the native
pancreas is never removed during a pancreas-kidney transplant.
Closing and Drainage Tubes
After the transplants are performed the
incision will be closed and the anesthesia team will wake the patient
from anesthesia. Several drainage tubes will be placed in the abdomen,
and a urine catheter is placed in the bladder and will remain for
several days after the transplant.
Transplant Procedure: Pancreas Transplantation Alone or Pancreas after Kidney Transplantation
This procedure is performed through the
same incision that would be made for a pancreas-kidney transplant. The
procedure is similar to that of a pancreas-kidney transplant except that
the kidney transplant portion is not performed.
Following pancreas or pancreas-kidney transplantation surgery the patient is taken to our dedicated Transplant Surgery Intensive Care Unit
(TSICU) for monitoring. Most patients spend two nights in this unit
before being transferred to the regular transplant surgery floor. The
vast majority of patients have immediate function of the transplanted
organs and will not require any dialysis or insulin after the transplant
Typically, pancreas and pancreas-kidney
transplant recipients will require 5-7 days of recovery in the hospital
after surgery. The urine catheter and IV will usually be removed on the
third day after surgery if a kidney transplant is performed with the