What Is A Pancreas Transplant?

The pancreas is an organ of the body found behind the stomach. It has a crucial role in maintaining blood sugar levels by producing the hormones glucagon and insulin which regulate the breakdown of glycogen to glucose and the absorption of sugar into the tissues and cells. Both these functions are disturbed in the case of diabetes mellitus.

For cases of severe diabetes, a pancreas transplant is considered a suitable option when the complication is life-threatening and there is no other way to cure it. 

A pancreas transplant surgery is performed by replacing the diseased pancreas with a healthy one (received from a deceased person). It is preferred when there is a complicated case history of a patient with type 1 diabetes which we will discuss below. This surgery is seldom used for pancreatic or bile duct cancer. Also, a fact is that it can be accompanied by a kidney transplant because, in most cases, kidneys are also affected by diabetes, which makes the situation even riskier.

Read more: 20 signs your pancreas is functioning badly.

Relation of the pancreas with diabetes

The pancreas maintains blood sugar levels, so when it is causing problems, it may be influencing the sugar levels of the blood. When sugar levels are high, the condition is called diabetes mellitus. There are two types of diabetes mellitus: type 1 and type 2.

Type 1 diabetes is genetic and it is an auto-immune disorder in which your body activates against the pancreas and refuses to identify its own cells. This means that it starts killing the insulin-producing cells; as a result, the body does not make enough insulin. That means blood sugar is not utilised by cells and remains in the blood.

The second is type 2 and it is usually caused by your lifestyle; it may be due to diet or hormonal imbalance or stress where the body is not producing insulin or that insulin is not doing the job. 

Read more: Do I have diabetes?

When does our pancreas need to be transplanted?

A pancreas transplant is used for those with type 1 diabetes when it is at the stage when it cannot be cured by medications and hormonal therapies. In less critical situations, medications and insulin administration on a routine basis are prescribed by health practitioners but if it is not working for a patient, a pancreas transplant will be used to improve the health of the patient.

It is not the best treatment but for a certain period. It can be helpful as our body will recover insulin production. Proper medications, light exercises and proper diet balance in life are required to increase the chances of a successful transplant.

Read more: When to worry about pancreatitis?

The types of pancreas transplants

A pancreas transplant is completed by surgical grafting a healthy organ taken from a deceased person’s body (whose brain is not dead yet) to the patient (recipient). A proper consent letter is taken from both parties to avoid any ethical issues.

Pancreas transplants can be of four types. 

1. A pancreas transplant alone (PTA) in which only a pancreas is transplanted. 
2. A simultaneous kidney-pancreas transplant (SKP), which is when it is accompanied by a kidney transplant.
3. A pancreas-after-kidney transplant (PAK), in which you get a kidney transplant first and then, after full recovery, head towards a pancreas transplant.
4. The last type includes the injections of islet cells (insulin-producing) into the vein supplying the liver but it is still an experimental trial.

How is a pancreas transplant performed?

A pancreas transplant utilises the same surgical procedure as any other transplant surgery. However, it depends on if you are having the PTA or SKP.

1. Firstly the recipient's problematic organ is removed while avoiding blood loss and using general anaesthesia.
2. The donor’s organs are then grafted into the recipient's body by proper suturing and attaching vessels to the newly introduced organ in the recipient's body.
3. Complete bed rest for at least one week is advised by medical professionals after the surgery. Immune-suppressing drugs are given because otherwise, even if tissues match perfectly, the body’s immune system will try to hinder its functioning.

What happens before and after an organ transplant?

Before the transplant, the pancreas tissues of the donor and recipient are matched, which is quite a task. Even after a transplant, tissue rejection may occur after some period of time.

Significant age and body mass index as well as risk factors for rejection of grafted pancreas tissue differences between donor and recipient are taken into account before the transplant. These factors can include: death due to trauma, alcohol consumption or smoking and high serum lipase levels. But above all of them, a donor who died of cardiovascular problems is the major risk factor for transplant failure. However, sometimes the transplant is of no use because the newly grafted tissue is not working in the recipient’s body. Bleeding, blood clotting or rejections are commonly occurring issues and studies are being conducted to reduce this occurrence.

Conclusion: 

A pancreas transplant is an occasional surgery performed in case of complicated type 2 diabetes in which external therapy is no longer giving a response and alternative options must be considered. However, it can be problematic because extra care is required for the patient and specific rules and regulations have to be followed to avoid chances of the grafted tissue being rejected. To live a healthy life after an organ transplant, the patient needs to change their living style completely and start adopting healthy life habits. Eating junk foods, a large amount of workload, a stressful environment, alcohol consumption etc., are triggering factors for tissue refusal. Patients must take medication (to suppress the immune system) against rejection of transplant which also causes some side effects.