Pancreas transplant surgery

Pancreas transplantation is a surgical procedure where you receive a healthy donor pancreas. The Penn Medicine pancreas transplant team specializes in both pancreas-alone transplants as well as dual organ pancreas-kidney transplants.

Pancreas transplantation is most typically a treatment for people with type 1 diabetes who experience complications from this condition. In rare cases, people with type 2 diabetes acute pancreatitis, or other pancreatic disease or injury may be eligible. Most of the pancreas transplants we perform at Penn Medicine are dual organ pancreas-kidney transplants for people with type 1 diabetes and kidney failure.

In general, pancreas transplant candidates must be healthy enough to undergo the procedure and free of:

• Active infections such as hepatitis
• Cancer
• Heart, lung, and blood vessel diseases

When we identify a potential match for your transplant, our nurse coordinator will call and let you know to come to the hospital.

We know your loved ones play an important role supporting you through your transplant journey, and they’re welcome to stay with you until you’re ready for surgery. Your team will update them on your progress throughout the procedure.

A pancreas transplant takes up to six hours; a simultaneous pancreas-kidney transplant may take twice as long. You’ll be under general anesthesia during the surgery to keep you asleep and comfortable.

Your surgeon makes one or more incisions in your abdomen and then positions the donor pancreas. Most recipients also keep their own pancreas. Your surgeon attaches your small intestine and blood vessels to the new pancreas and then closes all incisions with stitches.

While you’re still under anesthesia, we’ll move you to the surgical intensive care unit (ICU) and let your family know they can join you. You may need to spend a few days in the ICU, where we closely track your health and the function of the transplanted pancreas.

You’ll start taking immunosuppressant medications to reduce the chance of organ rejection. Your new pancreas will start making insulin right away, and we’ll carefully monitor your blood sugar levels.

After the ICU, you’ll continue to recover in a regular hospital room for up to two weeks. We’ll also educate you about your anti-rejection medications, how to protect your new pancreas, and what to expect as you heal. We welcome your loved ones to visit at all times and can include them discussions about your care.

When you leave the hospital, you’ll need to remain nearby for several weeks to attend frequent follow-up appointments. Local housing is available at the Clyde F. Barker Penn Transplant House and other nearby accommodations are also available.

We’ll perform medical tests and exams and support your recovery in every way. In the months and years after pancreas transplant, we continue to partner with you for all the transplant follow-up care and support you need.

All major surgeries have the risk of complications such as internal bleeding, blood clots, infections, and problems with healing. Pancreas transplantation has other risks including:

• Rejection of the donor pancreas: Rejection can happen when your immune system recognizes the new pancreas as foreign to your body and damages it. You take powerful immunosuppressant medications to prevent rejection and we monitor your new pancreas closely to identify signs of rejection early.
• Duodenal graft complications (DGC): This is a problem with the attachment between the new pancreas and your small intestine.
• Pancreatic fistula: A fistula is an abnormal connection that forms between two organs or structures in the body. A pancreatic fistula can form when the pancreas leaks fluid and the new pancreas connects to another organ.
• Pancreatitis: This is an inflammatory condition of the pancreas.
• Primary graft failure: Sometimes a transplanted organ never functions properly, and this organ failure can lead to organ rejection. We monitor closely for this complication in the days and weeks after surgery.

Our pancreas transplant program was the first in the region, and we remain one of the world’s leading centers in pancreas transplant medicine. The Penn Medicine Transplant Institute surgeons are experts in their field, sought after by their colleagues worldwide for consultations and training. We are experts in rare kidney-pancreas dual-organ transplants, which most centers don’t offer.

Penn Medicine is recognized by the National Pancreas Foundation as a center of excellence for our innovative care of patients with pancreas disease. You’re at the center of everything we do, as we constantly strive to improve the lives of our pancreas transplant patients.