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Pancreas transplant: An insulin-free treatment for type 1 diabetes
A pancreas transplant is a potential cure for advanced type 1 diabetes. Learn what to expect of the transplant process, the surgery itself and follow-up care.
By Mayo Clinic staffType 1 diabetes is a condition in which your pancreas produces little or no insulin, a hormone that allows sugar (glucose) to enter your cells. Treatment for type 1 diabetes is a lifelong commitment of monitoring blood sugar, taking insulin, eating healthy foods and maintaining a healthy weight. For some people, however, insulin therapy and healthy lifestyle choices aren't enough.
If you have severe type 1 diabetes that isn't being successfully managed with insulin therapy, you might be a candidate for a pancreas transplant. A successful pancreas transplant may eliminate the need for insulin therapy.
How does the pancreas lose its ability to produce insulin?
The pancreas releases enzymes into your small intestine to break down nutrients. It also releases hormones into your bloodstream to help your body use glucose. One of these hormones, insulin, lets glucose enter your cells. Glucose is a main source of energy for the cells that make up your muscles and other tissues.
Throughout the pancreas are clusters of specialized cells that produce insulin. When you have type 1 diabetes, your immune system — which normally protects you from viruses and bacteria — attacks and kills these cells. This may occur through a combination of factors, including a genetic predisposition or exposure to certain viruses.
Without insulin, glucose can't get into your cells. Lack of insulin can lead to potentially fatal complications. High blood sugar, which can eventually damage your blood vessels and other tissues, is a particular concern. Your eyes, nerves and kidneys are particularly susceptible to this damage.
Who might be considered a candidate for a pancreas transplant?
A pancreas transplant offers a potential cure for type 1 diabetes, but it's not a standard diabetes treatment. Often, the side effects of a pancreas transplant are more serious than the diabetes. If your diabetes treatment plan is working, a pancreas transplant isn't likely a better option. But if your diabetes can't be controlled or you have serious diabetes-related complications, a pancreas transplant may be worthwhile.
The lack of suitable donor pancreases is a major obstacle in the use of pancreas transplants.
Are there different types of pancreas transplants?
If you have frequent insulin reactions or poor blood sugar control and relatively healthy kidneys, your doctor may recommend a pancreas-only transplant. Often, however, a pancreas transplant is combined with a kidney transplant or done after a successful kidney transplant. The strategy is to give you a healthy kidney and a pancreas that's unlikely to contribute to diabetes-related kidney damage in the future.
You might also be a candidate for an islet cell transplant. With this experimental transplant procedure, only the insulin-producing cells from a donor pancreas — not the entire organ — are transplanted into your body.
What should I consider when choosing a transplant center?
If your doctor recommends a pancreas transplant — either alone or combined with a kidney transplant — you may be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.
When you're considering transplant centers, ask about the number and type of transplants the center performs each year, as well as its organ and recipient survival rates. You can compare transplant center statistics through a database maintained by the Scientific Registry of Transplant Recipients.
Also consider additional services provided by the transplant center. Many transplant centers coordinate support groups, assist with travel arrangements, help secure local housing for the recovery period and offer referrals to other helpful resources.
Do I need to be accepted by the transplant center?
When you select a transplant center, you'll need an evaluation to determine whether you meet the center's eligibility requirements for a pancreas transplant. The team at the transplant center will assess whether you:
- Are healthy enough to have surgery and tolerate lifelong post-transplant medications
- Have any medical conditions that would hinder transplant success
- Are willing and able to take medications as directed
- Have family and friends to support you during this stressful time
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