A pancreas transplant is surgery to implant a healthy pancreas from a donor into a patient with diabetes. Pancreas transplants give the patient a chance to become independent of insulin injections.

The healthy pancreas is obtained from a donor who has suffered brain-death, but remains on life-support. The donor pancreas must meet numerous criteria to make sure it is suitable.

In addition to insulin, the pancreas produces other secretions, such as digestive enzymes, which drain through the pancreatic duct into the duodenum. Therefore, a portion of the duodenum is removed with the donor pancreas. The healthy pancreas is transported in a cooled solution that preserves the organ for up to 20 hours.

The patient's diseased pancreas is not removed during the operation. The donor pancreas is usually inserted in the right lower portion of the patient's abdomen and attachments are made to the patient's blood vessels. The donor duodenum is attached to the patient's intestine or bladder to drain pancreatic secretions.

The operation is usually done at the same time as a kidney transplant in diabetic patients with kidney disease.

A pancreas transplant may be recommended for people with pancreatic disease, especially if they have type 1 diabetes and poor kidney function.

Pancreas transplant surgery is not recommended for patients who have:

• Heart or lung disease
• Other life-threatening diseases

Solitary pancreas transplant for diabetes, without simultaneous kidney transplant, remains controversial.

The risks for any anesthesia are:

• Heart attack
• Reactions to medications
• Problems breathing

• Bleeding
• Infection
• Scar formation

The main problem, as with other transplants, is graft rejection. Immunosuppressive drugs, which weaken your body's ability to fight infections, must be taken indefinitely. Normal activities can resume as soon as you are strong enough, and after consulting with the doctor. It is possible to have children after a transplant.

The major problems with all organ transplants are:

• Finding a donor
• Preventing rejection
• Long-term immunosuppression

It usually takes about 3 weeks to recover. Move your legs often to reduce the risk of blood clots or deep vein thrombosis. The sutures or clips are removed about two to three weeks after surgery. Resume normal activity as soon as possible, after consulting with the physician. A diet will be prescribed.

Robertson RP. Pancreas and islet transplantation in type 1 diabetes.Diabetes Care. Apr 2006; 29(4): 935.

Larson-Wadd K. Pancrease and islet cell transplantation. Anesthesiol Clin North America. Dec 2004; 22(4): 663-74.