Pancreas transplant 

A pancreas transplant is an operation to treat diabetes by replacing the need for insulin with a healthy insulin-producing pancreas from a donor who has recently died.

The pancreas is an organ in the abdomen that produces both digestive juices and hormones, such as insulin, that help the body break down food and turn it into energy.

A pancreas transplant is sometimes recommended as a treatment for people with insulin-treated diabetes, such as type 1 diabetes, who are unable to produce their own insulin.

This page covers:

Why they're carried out

What happens

Recovery

Risks

Outlook

Why pancreas transplants are carried out

A pancreas transplant allows people with type 1 diabetes to produce insulin again. It is not a routine treatment because it carries significant risks, and treatment with insulin injections is often effective.

A pancreas transplant is usually only considered if:

• you also have severe kidney disease – a pancreas transplant may be carried out at the same time as a kidney transplant in these cases
• you have severe episodes of dangerously low blood sugar levels (hypoglycaemia) that occur without warning and aren't controlled with insulin

If your doctor thinks you might benefit from a pancreas transplant, you'll need to have a detailed assessment to check whether you're healthy enough to have one, before being placed on a waiting list.

Read more about who can have a pancreas transplant and being on the pancreas transplant waiting list.

What happens during a pancreas transplant

A pancreas transplant needs to be carried out as soon as possible after a donor pancreas becomes available.

The procedure is performed under general anaesthetic, where you're asleep.

A cut (incision) is made along your tummy. The donor pancreas – and donor kidney, if you're having a kidney transplant at the same time – is then placed inside, and attached to nearby blood vessels and your bowel.

The new pancreas should start producing insulin straight away. Your old damaged pancreas will be left in place and will continue to produce important digestive juices after the transplant.

Read more about how a pancreas transplant is performed.

Recovering from a pancreas transplant

You'll usually need to stay in hospital for around two or three weeks after a pancreas transplant. Most people are able to get back to their normal activities within a few months.

Your transplant team can give you advice about how long you may need to avoid certain activities during your recovery.

You'll need to have regular check-ups with your transplant team after the transplant.

You'll also need to take medications called immunosuppressants for the rest of your life. Without these medicines, your body will recognise your new pancreas as foreign and attack it – this is known as rejection.

Read more about recovering from a pancreas transplant.

Risks of a pancreas transplant

A pancreas transplant is a complex and risky procedure.

Possible complications include:

• the immune system recognising the transplanted pancreas as foreign and attacking it (rejection)
• blood clots forming in the blood vessels supplying the donor pancreas (thrombosis)
• short-lived inflammation of the pancreas (pancreatitis), usually just after transplantation
• side effects from the immunosuppressant medication, such as an increased chance of catching certain infections, developing high blood pressure, and weakened bones (osteoporosis)

Many of these problems are treatable, although sometimes it may be necessary to remove the donor pancreas.

Read more about the risks associated with a pancreas transplant.

Outlook for a pancreas transplant

The outlook for people with a pancreas transplant is usually good:

• most people live for many years, or even decades, after a pancreas transplant – 97% will live at least a year afterwards, and almost 90% will live at least five years
• for people who had a pancreas and kidney transplant together – around 85% of donor pancreases are still working after one year, and around 75% are still working after five years
• for people who just had a pancreas transplant – around 65% of donor pancreases are still working after one year, and around 45% are still working after five years

The donor pancreas can be removed if it stops working, and it may be possible to put you back on the waiting list for another transplant.