The Center for Transplantation at UC San Diego Health System provides comprehensive and innovative treatment for people in need of a pancreas. Below, find information on pancreas transplantation and combined kidney-pancreas transplantation. For more detailed information on kidney transplantation, see Kidney Transplant Program.
UC San Diego Health System’s pancreas and combined kidney-pancreas transplant program is the first and largest academic program in San Diego County.
Pancreas Transplantation: Meetings for Patients and Families
- Waiting list
- Expanded donor list
- Financial issues
- Life after transplant
Programs are held 3 to 4 times a month in English and Spanish. Call 619-574-8612 for current schedule.
Background on Pancreas Transplantation
The primary indication for pancreas transplantation is type 1 diabetes, an autoimmune disease affecting three million people in the United States. Type 1 diabetes occurs when the body’s immune system attacks the insulin producing cells in the pancreas. Without insulin, people can’t live, so people with type 1 diabetes replace insulin through multiple daily injections or infusion through an insulin pump. Pancreas transplantation offers some people with type 1 diabetes the opportunity to be free of insulin injections and halt complications of the disease. Complications of type 1 diabetes include blindness, amputation, nerve damage, heart disease and kidney disease. A pancreas transplant is rarely done alone because of risk of significant side effects from the medications required after transplantation. Pancreas-only transplantation is an option, however, for people with life threatening complications of type 1 diabetes who do not have kidney failure.
Background on Kidney-Pancreas Transplantation
Unlike kidney transplantation, the pancreas is not commonly transplanted on its own. Rather, it is usually done in combination with a kidney transplant. When a person with type 1 diabetes who has developed chronic kidney disease as a complication of the diabetes reaches the point of dialysis, he or she may be a candidate for both a kidney and pancreas transplant at the same time. The advantage of this type of dual-organ transplant is that it involves one surgical procedure and uses a single donor, reducing the risk of rejection. In most cases, a kidney-pancreas transplant is performed from a deceased donor, but there have been several transplants performed using a living donor kidney and a deceased donor pancreas. Like all organ transplant recipients, people who have had a kidney-pancreas transplant take several medicines to fight rejection and infection for the rest of their lives.
The Center for Transplantation is one a few programs nationally that offers combined transplantation to select patients with type 2 diabetes and kidney failure. Type 2 diabetes is often associated with obesity and insulin resistance, and a new pancreas does not make enough insulin to overcome these factors. However, select patients with type 2 diabetes who are not obese, have low insulin requirements, and have kidney failure may benefit from combined kidney and pancreas transplantation.
Pancreas or kidney-pancreas transplantation is not recommended for individuals with cardiac, pulmonary or liver disease. Patients with cancer, active infection, or who are very deconditioned would also not be candidates.
Types of Kidney Transplantation
UC San Diego Health System experts have extensive skills in deceased and living donor kidney transplant procedures, including minimally invasive robot-assisted nephrectomy and paired kidney transplantation. Read about types of kidney transplantation at Kidney Transplant Program.
Types of Pancreas Transplanatation
A kidney-pancreas transplant usually comes from a single deceased donor to reduce rejection risk from multiple donors. By performing the kidney and pancreas transplantations simultaneously, the recipient incurs the risks involved in major surgery only once. Our center specializes in:
- Simultaneous Kidney-Pancreas (SKP) – transplant of deceased donor kidney and pancreas
- Pancreas After Kidney (PAK) – transplant of a deceased donor pancreas is performed after a living or deceased donor kidney transplantation
- Pancreas Alone Transplantation
- Re-transplantation – of the kidney and the pancreas
Overview of Pancreas Transplantation
After a thorough evaluation, the transplant team will talk to you and your family about being placed on the national transplant waiting list for a pancreas or kidney and pancreas. The donor needs to have a compatible blood type with the recipient. Gender, age or race does not need to match. Read more about organ donation and allocation and about the steps involved before surgery.
The risks in transplantation surgery are those that are common to all forms of major surgery. There could be technical difficulties in implanting the donor pancreas or kidney and pancreas. Leakage or blockage of urine could occur. Immediately after the operation, risks include bleeding, poor function of the grafted pancreas or kidney and pancreas, and infections. We monitor transplant recipients carefully after surgery for signs the body is rejecting the new organ(s).
Surgery and Recovery
A pancreas-only transplantation procedure takes about three hours. The recipient's own pancreas is left in place and the donor pancreas is transplanted into the abdomen. The Center for Transplantation offers advanced surgical techniques, including connecting the transplanted pancreas into the recipient's small intestine. This method is less prone to complications than the earlier procedure that involved attaching the pancreas to the bladder.
A combined kidney-pancreas transplant procedure takes approximately five to seven hours to complete. The new kidney is attached to the vessels that take blood to the leg. In most cases, your own kidneys and ureter are not disturbed. Read more about kidney transplant surgery.
During your recovery, the transplant team makes daily rounds and provides training on transplant medications. Recovery in the hospital may take one to two weeks, and resuming normal activities may take upwards of a year. Quality of life usually improves dramatically and most people lead healthy, normal lives.
Following discharge from the hospital you will attend the post-operative follow up clinic twice a week for the first six weeks after surgery with the transplant team and continue to be followed up at the clinic. Read more on care after surgery for kidney and pancreas transplantation.