바로가기 메뉴

단축키 목록

맨 위로

What Is a Pancreas Transplant?

Pancreas transplantation is performed to cure insulin dependent diabetes . In this type of grafting, the whole pancreas or part of it from the donor is directly connected to the recipient’s vascular system to maintain a normal blood circulation to the graft.

Anatomy and Physiology of Pancreas

The pancreas secrets not only digestive juice but also various hormones that regulate the blood sugar level. Cells that secret those hormones exist in islets in the organ and thus, they are called islet cells.
Among the cells, beta cells produce insulin that lowers a high blood sugar level while alpha cells make glucagon which raise the level when it is too low.

Why Is a Pancreas Transplant Necessary?

Though diabetes is controllable with insulin, it is not sufficient to prevent secondary complications and stop their development. In this sense, transplantation is an ultimate treatment to diabetes and related complications.

Types

1. Simultaneous Pancreas-Kidney Transplantation (SPK)

This type of surgery is conducted for patients with chronic diabetic renal disorders

It is the most common type of pancreas transplantation and shows the highest survival rates of recipients and grafts compared to the other two types. This is because rejection reactions can be monitored everyday and readily treated by checking the blood creatinine level which reflects the status of the transplanted kidney. Checking the kidney is enough as it is rare that the pancreas shows rejection reactions alone.

2. Pancreas transplantation After Kidney transplantation (PAK)

In this type of surgery, first the kidney is successfully transplanted to patients with chronic diabetic renal disorders and then, the pancreas is grafted later to prevent advancement of diabetes and related complications.

3. Pancreas Transplantation Alone (PTA)

The pancreas alone can be transplanted to patients with end-stage diabetes who have not developed renal disorders yet.

Indications

  • Primarily, childhood diabetics (Insulin Dependent DM : IDDM, type 1 DM)
  • Patients with insulin-dependent maturity-onset diabetes
  • Patients with diabetic renal disorders (those who receive dialysis treatment or require a kidney transplant urgently are eligible for SPK or PAK)
  • Diabetics who have difficulties in controlling the blood sugar level with insulin and frequently experience hypoglycemia in the early morning (eligible for PTA)
  • Patients who received total pancreatectomy

Contraindications

  • Patients whose blood sugar level is well controlled with insulin
  • Patients with symptoms of infection
  • Patients who have peripheral tissue gangrene such as coronary insufficiency with severe angina pectoris
  • Patients over 60