Who can have one
As donor pancreases are scarce, you'll need to be assessed carefully to determine whether a pancreas transplant is suitable for you and you could benefit from one.
A pancreas transplant is usually only considered in a small number of people with type 1 diabetes.
There are around a million people in the UK with type 1 diabetes, but only about 200 get a pancreas transplant each year.
Type 1 diabetes happens when the immune system destroys the cells (islets) in the pancreas that produce a hormone called insulin.
It can often be controlled with insulin injections, so the risks of a pancreas transplant outweigh the benefits in many cases.
But a transplant may be considered if:
- you also have severe kidney disease, whether it's caused by diabetes or not – a pancreas transplant may be carried out alongside a kidney transplant in these cases
- you have severe episodes of a dangerously low blood sugar level that happen without warning, in spite of good insulin control
If a healthy pancreas is transplanted into your body, it should start producing insulin immediately, relieving diabetes symptoms and replacing treatment with insulin injections.
You'll have a detailed assessment at a transplant centre to find out more about your health and check whether there are any underlying problems that could affect your suitability for a pancreas transplant.
This will usually involve having several tests, such as:
- checks of your blood pressure and heart rate
- measurements of your height and weight
- urine and blood tests
- a chest X-ray
- a type of ultrasound scan used to examine your blood vessels (a Duplex scan)
- an ultrasound scan of the heart (an echocardiogram)
- tests to measure the electrical activity of your heart (an electrocardiogram, or ECG)
- a type of X-ray used to study the inside of your heart (cardiac catheterisation and coronary angiography)
You'll also have the opportunity during your assessment to meet the transplant team and find out more about the operation.
You may find it useful to write down a list of questions you'd like to ask the transplant team before your visit.
Unfortunately, not everyone who thinks they'd benefit from a pancreas transplant will be suitable for one.
This is because the operation places a major strain on the body and may mean the risks outweigh the potential benefits.
For example, you may be considered unsuitable for a pancreas transplant if you:
- have severe heart disease
- have recently had a heart attack
- have incurable cancer
- have a serious mental health or behavioural condition that means you'd be unlikely to be able to correctly take the medication needed after a pancreas transplant
- are generally in poor health and are unlikely to withstand the strain of surgery and the treatment that follows it
- are very overweight
- drink heavily or abuse drugs
Age is not a factor in determining whether a pancreas transplant is suitable, although the procedure is rarely performed in older people because they often have other health problems that mean a transplant is too risky.
The final decision about whether you're suitable for a pancreas transplant is made by the transplant team.
You may be informed about the decision before leaving the transplant centre.
But if your case is not straightforward, it may be several weeks before you're told the decision.
The transplant team may decide you're:
- suitable for a transplant and ready to be placed on a waiting list – read more about being on the pancreas transplant waiting list
- suitable for a transplant, but your condition does not require a transplant – you'll usually be monitored in case your condition gets worse
- unsuitable for a transplant – the reasons will be explained in detail by your transplant team
In some cases, further tests are necessary to make a final decision, or you may be referred to a different transplant centre for a second opinion.