Restoring the insulin levels by regular subcutaneous injections is the mainstay of treatment of Type 1 diabetes. In some well-defined cases a pancreas transplant may be considered. A pancreas transplant is a surgical procedure with the aim to transplant a pancreas from a donor, whose sudden death has provided the opportunity to harvest a healthy organ, into a person with diabetes. Restoration of insulin secretion and maintenance of normal blood glucose levels is the marker of a successful transplant.
Pancreas transplantation by no means represents an easy or straightforward option.
First there is a shortage of donor organs for transplantation. The transplant team can only obtain an organ from a recently deceased donor. A complex organization of donor organ collection and selection is required before the procedure can be undertaken.
Secondly there are the obvious surgical risks and complications associated with any major surgery.
Thirdly a pancreas transplant cannot be successful without the patient taking anti-rejection drugs, the long-term side effects of these are very considerable and usually considered more serious than the diabetes itself.
A pancreas transplant is sometimes offered because it offers a potential cure for Type 1 diabetes in patients who have very big problems associated with their diabetes. In these people the benefits may outweigh the risks. Patients put forward for a pancreas transplant may for example have already developed severe kidney failure and a combined kidney and pancreas transplant may offer the best chance of restoring that person to health. A single pancreas transplant is considered in some patients whose life is consistently and significantly disrupted by poor diabetes control and which is unresponsive to standard treatment.
After a successful transplant has been performed patients will have to attend for hospital checkups on a regular and frequent basis. This is to monitor the progress of the transplant function and to detect for any potential complications of the treatment.
Lifelong immunosuppressant medications are necessary to prevent your immune system from attacking and rejecting the transplanted organ. Additional treatment to help reduce the risk of infections such as antibacterial, antiviral and antifungal drugs will also be considered.
The results of the treatment can be judged in terms of whether the transplanted pancreas is still functioning after a certain time of study but this should be judged in the long term and at least several years. The success rates vary considerably according to the different transplant centers around the world. A reasonable and current figure would be a successfully functioning pancreas transplant in about 80 to 90 per cent of people one year after the procedure. After five years this figure reduces to about 50 to 70 per cent depending on whether the original procedure was a simultaneous pancreas-kidney transplant, pancreas after kidney transplant or a pancreas only transplant.