Recovery

The Transplant Process - Transplant Surgery

You’ll be contacted when a pancreas (or kidney and pancreas if it’s a combined kidney-pancreas transplant) is available. If your new organ is from a living donor, both you and the donor will be in surgery at the same time. One team of surgeons will remove a section of pancreas (and a kidney, if it’s kidney-pancreas transplant) from the donor while another prepares you to receive the donated organs.

If your new organ(s) is from a person who has recently died, your surgery starts when it arrives at the hospital. The pancreas must be transplanted into the recipient within 12 to 15 hours.

A pancreas-only transplant can take from 2 to 4 hours or more; the combination kidney-pancreas transplant can take about 5 to 7 hours or more. After you’re given general anesthesia, the surgeon makes an incision in your abdomen. If you’re having a pancreas only transplant, the new pancreas can be put on your right or left side. If you’ve already had a kidney transplant, the new pancreas will be put on the side opposite the kidney. If you’re having a combined kidney-pancreas transplant, the pancreas is often placed first, on the right side; the kidney is then placed on the left. In all cases, your diseased pancreas is not removed, but left in place.

To restore blood flow to the new pancreas, it’s connected to a major artery and a major vein. The beginning of the small intestine (called the duodenum) from the donor pancreas is connected to your intestine or bladder.

If you’re also having a kidney transplant, the artery and vein of the new kidney will be connected to your own artery and vein. Your blood will then flow through the new kidney. The ureter from the new kidney will be connected to your bladder.

The Transplant Process - Recovery in the Hospital

You’ll probably stay in the hospital for about a week or two after surgery. Immediately after surgery, you’ll be taken to the Surgical Intensive Care Unit (SICU). After a day or so there, you’ll go to the Inpatient Transplant Unit where you’ll take medicines to prevent infections and rejection of your new pancreas. Your doctor will check for possible post-operative problems, such as:

• Clotting of major vessels: If the major artery and vein that supplies blood to the pancreas becomes blocked, the pancreas can fail and will have to be removed.
• Major bleeding: Sometimes (not often) small blood vessels in the new pancreas bleed and need to be tied off in a second surgery.
• Leaking from intestinal connection: If the bowel doesn’t heal together after the transplant surgery, there may be leakage and infection and a second surgery may be needed to repair this.
• Pancreatitis: This is an inflammation of the new pancreas that can prevent it from working right or cause fluid accumulation in the abdomen and/or pain.

You’ll also be prepared for your return home. You’ll be given a schedule for follow-up visits and routine blood draws, and a 24-hour phone number for emergencies or other problems. You’ll learn how to deal with the medicines you’ll be taking and their side effects, recognize rejection symptoms, plan proper diets and generally take responsibility for your recovery at home. The transplant coordinator, social worker, and psychiatrist are all available when needed. The social worker will help arrange your discharge needs, such as rehabilitation or long-term placement, chemical dependency counseling, and transportation home. You’ll also be offered a referral to a community health nurse who can help you at home.