Coronavirus: pancreatic transplant update
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Types of pancreas transplants
There are two common types of pancreas transplants:
- the combined, simultaneous pancreas and kidney (SPK) transplant. This is where the pancreas and kidney are provided from a dead donor.
- a pancreas-after-kidney (PAK) transplant. This is where the patient has a living donor kidney transplant (more rarely a deceased donor kidney transplant) and at least four months after this, has a pancreas transplant (from a dead donor).
Under certain circumstances it's also possible to transplant just the pancreas for patients with diabetes. Transplantation of the islets (specialised cells that produce insulin) alone is also feasible and trials are underway. This does not involve an open operation – the cells are injected into the liver through a long needle which crosses the skin. A small number of patients may benefit from this, but it is still a procedure under evaluation, with no long-term follow-up results. More information can be found on the Diabetes UK website.
Frequently asked questions
What are the benefits of having both
The main benefit of having both a pancreas and transplant is to improve quality of life in the long-term, with freedom from:
- dialysis and insulin injections
- daily blood sugar tests (BMs)
- the dietary restrictions of diabetes and kidney failure.
Diabetes can result in complications affecting the kidneys, eyes, nerves and causes "furring-up" of the arteries. A pancreas transplant may prevent these complications from worsening, and in some cases it may actually improve matters in the long-term (after several years). The pancreas transplant improves the long term survival of the kidney transplant compared to having a kidney transplant alone.
Why have a combined (simultaneous) transplant?
This involves a single surgical procedure and the pancreas will remove the need for insulin injections, protecting you from the consequences of diabetes.
This is a longer procedure and it takes you longer to recover compared to having the organs transplanted in 2 different operations.
Why have a pancreas-after-kidney transplant?
This gives you the best quality kidney (as it comes from a living donor) and it is a smaller operation than the combined one. The pancreas operation is done later (at least 4 months) after your full recovery from the kidney transplant. It also allows you control over the timing of the kidney transplant.
You would have two operations, but this may be outweighed by the other benefits.