During and after your transplant

Pancreas after kidney transplant

You will be given a general anaesthetic before your operation. A general anaesthetic gives a state of controlled unconsciousness. This is like being asleep and you do not feel any pain.

A large cut is made in your tummy (abdomen). The artery and vein of the pancreas are usually sewn into your artery and vein in the right-hand side of your lower tummy. The intestine that comes attached to the pancreas is sewn into your intestine. The pancreas usually starts producing insulin a few hours after the transplant.

The operation usually takes 3 to 4 hours. Your own pancreas is not removed and is left in place.

Pain during your transplant

As the operation is done under general anaesthetic, you should not feel any pain. You will feel some pain after the operation, but you will be given strong painkillers into your vein. You can control the amount of painkiller you receive by pushing a button on a patient-controlled analgesia (PCA) pump. It is regulated so that you cannot overdose. Most patients feel comfortable within hours of the operation.

After your transplant

For the first few days after the transplant, you will be cared for in the critical care unit (also known as intensive care). You will have a catheter (flexible tube) to drain pee (urine) from your bladder. You will also have tubes (drains) coming out of your tummy, and a tube in your neck to give fluids into your veins. Your blood sugars, urine output (how much you pee), and blood tests will be monitored to check how your transplanted pancreas is working.

When you are well enough, you will be moved to Richard Bright ward. The catheter will be removed 3 to 5 days after the operation. Most patients can eat and drink within the first few days after the operation.

Most people stay in hospital for about 2 weeks after the transplant. If you need more surgery, or there is a problem with the transplant, you might need to be in hospital for longer.

Leaving hospital

Before you leave the hospital, the pharmacist will tell you what each of your medicines are for, and how to take them. You will be given information about how long to rest, how to remove dressings, and pain relief.

A few months after the transplant you will be sent an appointment at Guy’s Hospital for a mixed-meal tolerance test. This tells us how well your pancreas is working. It involves drinking a mixture of protein, fat, and carbohydrate that tastes like a milkshake. Blood tests will be also be done to see how much insulin your pancreas is producing.

We might recommend that you have a pancreas biopsy. A tiny piece of tissue is removed from the pancreas and examined under a microscope. The biopsy helps us make sure that the pancreas is not being rejected.

How long the transplant will last

Between 70 and 80 out of 100 pancreas transplants are still working 1 year later. On average, this type of pancreas transplant lasts for 3 to 5 years. For some patients, the transplants last much longer and for others they might only last a short time. The length of time depends on the age of the donor, other medical conditions that the donor may have, and many other factors.

If your transplant fails

Some people can have another pancreas transplant if their transplant fails. The success rate for second transplants is generally as good as for the first. However, you are likely to wait longer. You will also need to go through the same tests again to make sure you are healthy enough to have another transplant. It is important that your kidney transplant is not damaged by having another pancreas transplant.