Surgeons perform pancreas transplants with general anesthesia, so you’re unconscious during the procedure. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas to breathe through a mask or injects a liquid medication into a vein.
After you’re unconscious:
An incision is made down the center of your abdomen.
The surgeon places the new pancreas and a small portion of the donor’s small intestine into your lower abdomen.
The donor intestine is attached to either your small intestine or your bladder, and the donor pancreas is connected to blood vessels that also supply blood to your legs.
Your own pancreas is left in place to aid digestion.
If you’re also receiving a kidney transplant, the blood vessels of the new kidney will be attached to blood vessels in the lower part of your abdomen.
The new kidney’s ureter — the tube that links the kidney to the bladder — will be connected to your bladder. Unless your own kidneys are causing complications, such as high blood pressure or infection, they’re left in place.
The surgical team monitors your heart rate, blood pressure and blood oxygen throughout the procedure with a blood pressure cuff on your arm and heart monitor leads attached to your chest.
Pancreas transplant surgery usually lasts about two to four hours. Simultaneous kidney-pancreas transplant surgery takes a few more hours.
After the procedure
After your pancreas transplant, you can expect to:
Stay in the intensive care unit for a couple days. Doctors and nurses monitor your condition to watch for signs of complications. Your new pancreas should start working immediately, and your old pancreas will continue to perform its other functions.
If you have a new kidney, it’ll make urine just like your own kidneys did when they were healthy. Often this starts immediately. But in some cases, it may take up to a few weeks to reach normal urine production.
Spend about one week in the hospital. Once you’re stable, you’re taken to a transplant recovery area to continue recuperating. Expect soreness or pain around the incision site while you’re healing.
Have frequent checkups as you continue recovering. After you leave the hospital, close monitoring is necessary for three to four weeks. Your transplant team will develop a checkup schedule that’s right for you. During this time, if you live in another town, you may need to make arrangements to stay close to the transplant center.
Take medications for the rest of your life. You’ll take a number of medications after your pancreas transplant. Drugs called immunosuppressants help keep your immune system from attacking your new pancreas. Additional drugs may help reduce the risk of other complications, such as infection and high blood pressure, after your transplant.
After a successful pancreas transplant, your new pancreas will make the insulin your body needs, so you’ll no longer need insulin therapy to treat type 1 diabetes.
But even with the best possible match between you and the donor, your immune system will try to reject your new pancreas.
To avoid rejection, you’ll need anti-rejection medications to suppress your immune system. You’ll likely take these drugs for the rest of your life. Because medications to suppress your immune system make your body more vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications.