In many cases, severe diabetes leads to secondary diseases. Type 1 diabetics can suffer from chronic kidney failure, for example. If insulin therapy does not lead to an improvement, a pancreas transplant may be able to help. This leads to a restoration of insulin production and normalization of blood sugar levels.
Here you will find further information as well as selected specialists and centers for a pancreas transplant.
With well-controlled insulin therapy, diabetics can lead a largely normal life.
However, in around ten percent of diabetics, even intensive insulin therapy does not lead to sufficient metabolic control. This repeatedly gets out of control, leading to secondary diseases and life-threatening hypoglycemia.
Diabetics with severely damaged kidneys who require regular dialysis (blood washing) may need a pancreas transplant. This involves implanting thepancreas of a donor into the patient's body.
If, for example, a person suffers from a severely damaged kidney and requires regular dialysis (blood washing), a pancreas transplant may be an option.
However, this type of procedure is only performed if
The operation can be performed in different ways:
The type of transplant used depends on the individual case. Combined kidney-pancreas transplantation is performed most frequently. In this case, both the kidneys and the new pancreas come from the same donor.
A pancreas transplant alone can be carried out before kidney failure occurs.
Type 1 diabetes is a form of diabetes that usually develops in childhood and adolescence. The immune system of those affected produces antibodies that attack and destroy the body's own cells in the pancreas. These so-called beta cells, which belong to the islet cells, are responsible for the production of insulin.
The beta cells of the pancreas produce insulin. In people with type I diabetes, these cells are often destroyed © Henrie | AdobeStock
The body needs insulin to make the sugar molecules from the blood available for metabolism in the body. If the sugar does not reach the cells of the various organs and the muscle cells, they cease to function.
The islet cells of the pancreas are usually destroyed at a very young age in people with type I diabetes. For this reason, patients are forced to inject insulin regularly. This is the only way to get the sugar from the blood into the cells.
As the walls of the blood vessels cannot withstand high blood sugar concentrations, inflammation often develops there. This results in
This damage particularly frequently affects
A pancreas transplant is primarily considered if the kidneys have already stopped functioning. The results of clinical studies show that the chances of survival after a transplant are better than those of insulin-dependent patients.
The combined kidney-pancreas transplant is performed under general anesthesia and takes between three and four hours. Before the operation, the medical staff examine the patient one last time and prepare them for the anesthetic. They also check the donor organs and prepare them for the operation.
At the beginning of the operation, the surgeon - a specialist in pancreatic surgery - opens the abdominal cavity and the peritoneum. As there are more accessible veins on the right side of the body to which the organ can be connected, the pancreas is transplanted there. Once the abdominal cavity is open, the surgeon exposes the required arteries and veins and connects them to the blood vessels of the donor pancreas.
The patient's kidneys and pancreas are not removed.
In addition to insulin, the transplanted pancreas also produces digestive juices. In addition to the donor organ, the doctor therefore transplants a short piece of the duodenum. By connecting the piece of intestine to the small intestine, the doctor ensures that the secretions can drain away.
Treatment with immunosuppressive medication begins during the operation. This is intended to suppress the possible rejection of the donor organs by the immune system.
After the transplant, patients spend three to four days in the intensive care unit. It can take this long for the new organs to function properly. During the first few days, the patient is therefore often injected with insulin. Dialysis is also carried out.
It takes around three to four weeks before the patient is discharged from hospital. During this time, the doctors check that the new organs are functioning properly and monitor wound healing. The patient is also given immunosuppressive medication.
Every surgical procedure also involves risks.
The most common complication after a pancreas transplant is the rejection of the donor organs by the patient's own body. In such a rejection reaction, the recipient's immune system perceives the transplant as a foreign body.
To prevent this from happening, patients must take immunosuppressants for the rest of their lives. These are drugs that suppress the immune system's defense reaction.
In the weeks following the operation, the doctors check which dose of medication is required in each individual case. How high or low the rejection reaction is depends primarily on how well the cell characteristics of the donor and recipient match.
A distinction is made between three forms of rejection reactions:
Hyperacute rejection reaction: This reaction occurs either during the transplantation or in the hours afterward. The cause is the incompatibility of the blood groups or tissue characteristics of the donor and recipient. Today, such incompatibility is ruled out during the preliminary examination. This form of rejection therefore rarely occurs. If it does occur, the transplant must be removed and a new donor organ transplanted.
Acute rejection reaction: This reaction usually occurs within the first 90 days after the operation. However, it can also occur years after the operation. It is also due to the immune system perceiving the donor organ as a foreign body and activating various immune cells to destroy it. Doctors can usually treat the acute rejection reaction with medication.
Chronic rejection reaction: This type of reaction only occurs some time after the operation, sometimes even after several years. Here too, activated antibodies are responsible for the process. However, this takes place much more slowly and gradually. It may be necessary to adjust the immunosuppressants administered. Sometimes a new transplant is even necessary. This depends on the extent of the damage to the transplanted organ and the surrounding tissue.
Further complications of a pancreas transplant can include
If insulin therapy does not lead to adequate metabolic control, diabetics can develop life-threatening secondary diseases. The kidneys often gradually fail.
A pancreas transplant can be useful for people with type 1 diabetes with kidney damage. Experts emphasize the improved chances of survival after transplantation compared to those of insulin-dependent patients.
The operation does involve some risks. Your doctor will explain these to you carefully. Various immune system reactions against the transplanted organs may occur.
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