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Pancreas Transplant Procedure

Pancreas Transplant Procedure

The transplant process begins with admission when a donor pancreas or pancreas-kidney becomes available, and continues through transplant surgery.

Admission Process

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.

Dialysis

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.

First Incision

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 side.

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 center.

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.

Recovery

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 procedure.

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 pancreas transplant.