Transplant Institute
The Transplant Institute, part of the Department of Surgery, offers nationally recognized patient care, research programs, and education and training opportunities.
Eligibility & Evaluation for Pancreas Transplant
Deciding if a pancreas transplant is the right treatment for you
Contact Us
Criteria for Pancreas Transplant & Starting the Transplant Process
If you have Type 1 diabetes, your blood sugar may fluctuate widely even when you’re taking insulin. This can lead to a lower quality of life and put you at risk for problems such as kidney failure. A pancreas transplant might help you avoid complications related to your diabetes and allow you to live life more fully.
As a new pancreas recipient, you face a lifetime of responsibility to care for your new organ. However, a transplant could help you avoid daily sugar monitoring and insulin injections. It could also could result in fewer diet and activity restrictions.
The pancreas transplant team at Beth Israel Deaconess Medical Center (BIDMC) carefully looks at your physical health, mental well-being and support system. We can help you determine if a pancreas transplant is right for you.
Am I Eligible for Pancreas Transplant?
Most people who get a new pancreas have Type 1 diabetes. Some patients with Type 2 diabetes may qualify as well.
Being a good candidate depends on your physical health, emotional well-being and ability to manage medication and care plans.
A pancreas transplant may not be right for you if you have a mild case of Type 1 diabetes that responds well to insulin therapy and certain diet restrictions. But if you don’t want to deal with limitations to your diet, blood sugar monitoring or multiple insulin injections each day, you might want to consider a transplant.
Transplant can also can be helpful if you have “brittle” diabetes. Brittle diabetes can cause severe and sudden symptoms and complications.
More About Pancreas Transplant Eligibility & Evaluation
Your Initial Screening
Determining who qualifies for a pancreas transplant begins with an initial meeting with our Transplant Institute staff. The main goals of this initial consultation are to:
- Determine if a pancreas transplant is right for you.
- Determine if you are healthy enough to receive a new pancreas.
We help you prepare you for your operation. This can take a long time, and there is no guarantee when a deceased donor pancreas will become available.
Types of Pancreas Transplant
There are three options for pancreas transplant:
- Pancreas transplantation alone — If your blood sugar levels fluctuate despite insulin therapy, a pancreas transplant could help. The transplant helps you control your blood sugar and reduce your risk of kidney damage. The pancreas comes from a deceased donor.
- Simultaneous pancreas and kidney (SPK) transplant — SPK transplants occur when we transplant a pancreas and a kidney at the same time. Both organs come from the same deceased donor. You may benefit from an SPK transplant if you have kidney failure and diabetes.
- Pancreas after kidney (PAK) transplant — A PAK transplant occurs when surgeons transplant a pancreas from a deceased donor after you’ve already received a transplanted kidney. That kidney can come from a different deceased donor or from a living donor. When you’ve already had a kidney transplant, a pancreas transplant may help you control your diabetes and prevent diabetic kidney disease from developing again.
It's important to remember, transplant is an option only if you have Type 1 diabetes.
What Research Tells Us About Pancreas Transplants
Pancreas Transplant Alone: Sometimes you develop severe complications from Type 1 diabetes. These can include serious eye disease and life-threatening bouts of low blood sugar. A pancreas transplant alone may help in these cases.
When you have severe diabetes complications, you may have early signs of kidney disease. You may also not be aware that your blood sugar is dangerously low. This is called hypoglycemic unawareness. It causes you to pass out frequently because you don’t realize your blood sugar is getting low. Passing out while driving a car or sleeping can be life-threatening.
A new pancreas can help regulate your blood sugar so these problems don’t occur. It can also protect you against kidney disease and other long-term diabetes complications.
PAK Transplant: Getting a pancreas transplant after a kidney transplant can be beneficial in some cases. Often, a kidney becomes available from a living donor first. You will get a pancreas donation from a deceased donor later.
For medical and emotional reasons, a living donor may be your best option for your kidney transplant. A living donor offers you the chance of a preemptive kidney transplant — a transplant that occurs before end-stage kidney failure develops and you need dialysis.
It’s not clear why, but if you have diabetes and start dialysis, you typically don’t do as well as you would do if you had a transplant before dialysis. Experts believe it could be because diabetes increases your risk of other health conditions, including vascular problems. So a preemptive transplant — before you need dialysis — may help you do better after surgery.
In some cases, PAK may:
- Help your kidney transplant last longer.
- Improve your quality of life.
- Prevent kidney disease related to diabetes in your transplanted kidney.
- Return blood sugar levels to normal without the need for insulin injections.
- Stabilize, and possibly reverse, diabetes-related conditions such as kidney disease, nerve dysfunction and eye disease.
Evaluation & Medical Tests
When you’re considering an organ transplant, many different specialists are involved in assessing your health. Tests, including lab work, help evaluate your physical health. Behavioral health specialists gauge your mental and emotional well-being.
With a pancreas transplant, certain aspects of your evaluation are especially important. For example, with Type 1 diabetes, you can have narrowed or blocked coronary arteries (coronary artery disease) that restrict blood flow to your heart without having symptoms. A heart care specialist (cardiologist) will take part in your evaluation and do heart tests, such as an electrocardiogram (EKG), echocardiogram and exercise stress test. The tests help determine your risk for heart problems during or after surgery.
A kidney care specialist (nephrologist) also plays a role in your evaluation.
If you have hepatitis, you will see a liver care specialist (hepatologist).You will also see a doctor who focuses on infectious diseases.
Preparing for Transplant
If you qualify for a transplant, it’s your decision whether or not to move forward. If you decide surgery is the right option, we help you prepare for your pancreas transplant. We offer all the information you need and the care that will help you get ready.
A pancreas transplant is a major surgery. But depending on your health before transplant, it can offer you greater independence.
