Pancreas Transplant Surgery: What to Expect 

Pancreas Transplantation at the Transplant Institute

Surgical expertise and experience are especially important when you need a pancreas transplant. The Transplant Institute at Beth Israel Deaconess Medical Center (BIDMC) offers both.

Our Pancreas Transplant Program is one of the most active pancreas transplant programs in New England. Here, you find surgeons with extensive training in pancreas transplantation. We use the latest surgical techniques and protocols designed to prevent complications and minimize side effects. You also benefit from an entire team of organ transplant experts dedicated to providing you with exceptional care. From pre-transplant preparation through surgery and post-surgery recovery, you’re in excellent hands at BIDMC.

Your Pancreas Transplant Surgery

Well before your pancreas transplant, we get you prepared by helping you make any needed lifestyle changes and monitoring your health. When the call comes that an organ is available, you’ll be ready.

Once you arrive at the hospital and go into surgery, we give you general anesthesia. You won’t be awake or feel any pain during your procedure. Here’s what will happen:

• The surgeon makes a straight incision in the middle of your abdomen. It runs from above your navel to your pubic bone.
• The surgeon inserts the donor pancreas into the right side of your abdomen. We connect blood vessels from the new organ to the large arteries and veins that supply blood to your leg. Your existing pancreas is not removed. It stays in place to help with digestion.
• The new pancreas comes with a segment of small intestine attached.  
• The surgical team then closes your incision with staples or sutures and covers the area with a gauze dressing.
• If you also need a kidney transplant, the surgeon will usually place the kidney in the left side of your abdomen.
• The kidney is connected to the blood vessels that go to your leg.
• The surgeon attaches the donor ureter — the tube that carries urine — to your bladder
• The surgeon will also place a stent in the ureter. The stent is a plastic tube that holds the ureter open and protects it until it heals. The stent doesn’t cause any discomfort. A urologist will remove it during an office visit several weeks after surgery.
• Your original kidneys are not removed during a kidney-pancreas (SPK) transplant.

Surgery to transplant a pancreas alone usually takes two to four hours. A combined kidney and pancreas (SPK) transplant usually takes four to six hours.

Risks of Surgery

There are risks with any surgery, and general anesthesia in particular. But with advances in surgical techniques and breakthroughs in medication, transplanted pancreases are lasting longer and functioning better than they ever have. Some BIDMC transplant patients have had their new pancreas for more than 10 years. They enjoy improved survival rates and better quality of life.

Here at BIDMC, you benefit from improved surgical procedures, including the use of blood thinners after surgery to prevent clotting in the new organ. We rapidly withdraw steroids to help reduce side effects. We’ve also developed protocols for immunosuppressant medications that minimize the effects of chronic steroid use.

After Your Transplant Surgery

After surgery you go to our post-anesthesia care unit (PACU) where doctors and nurses monitor you closely. Recovery times vary for each patient. You can expect to be in the PACU for four to 12 hours. Your surgeon lets your family know how you’re doing during this time.

If you need more intense observation, you go to our surgical intensive care unit (SICU) for specialized care.

Once you’re stable, we move you to Farr 10, our inpatient recovery unit. There you will learn more about your recovery and what to expect.

Your new pancreas should start to make insulin right away. Initially you may need to take low levels of insulin to prevent stressing your new pancreas. Typically, you will be able to start eating two or three days after surgery. Barring any complications, you will be able to go home four to seven days after surgery.

If you had a simultaneous pancreas and kidney transplant, you may need dialysis if your new kidney does not produce urine right away. This can feel disappointing, but it doesn’t mean the kidney will never work properly.