Pancreas Transplant

Pancreas Transplant

Signs and Symptoms
Evaluation
Treatment

Evaluation

Patients with type 1 diabetes may be evaluated for pancreas and kidney-pancreas transplants. Patients with type 2 diabetes are less likely to be candidates for a pancreas transplant because they may be insulin-resistant and unable to reap the benefits of a pancreas transplant.

Although type 1 diabetes can develop at any age, type 1 diabetes most commonly occurs in children and young adults, which is why it was previously called juvenile diabetes. It is considered an autoimmune disease, meaning that the body's own immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Patients with type 1 diabetes have very little or no insulin and need to take insulin everyday.

Type 2 diabetes is the most common form of the condition. It usually is diagnosed in adults over the age of 40. About 80 percent of those patients are overweight. As children have become increasingly overweight, Type 2 diabetes is being diagnosed at younger ages.

Initially in type 2 diabetes, insulin is produced, but the insulin doesn't function properly, which leads to a condition called insulin resistance. Most people with type 2 diabetes suffer from both insulin resistance and decreased insulin production.

If you became insulin dependent — meaning that you need insulin injections — at the age of 18 or older, we will need blood test results that indicate your levels of C-peptide, a product of insulin production.

For the evaluation for a pancreas transplant, we will request a number of other tests. Some of them are:

• Blood tests, including an HIV (AIDS) test, within the last year.

• Chest X-ray within the last year.

• Creatinine clearance testing for those not on dialysis. This test, conducted over a 24-hour period, compares how much creatinine — a blood waste product — occurs in the blood and in the urine to evaluate kidney function.

• Echocardiogram within the last two years. This test uses sound to create a picture of heart function.

• Electrocardiogram (EKG or ECG) within the last year.

• Persantine thallium or comparable test within the last two years. This test involves intravenous application of persantine to help expand the arteries and replicate the effect of vigorous exercise, and of thallium, a radioactive isotope detected by X-ray.

• Stool guaiac, which is a test for blood in stools.

• Tuberculosis (TB) skin test.

Other tests may be required — depending on your gender, age and medical history — such as a colonoscopy, mammogram, Pap smear or prostate specific antigen (PSA) test. Additional testing may be ordered, based on results of these tests.

Any changes in your health will be reviewed by our selection committee, which includes all transplant doctors and nurses. Your transplant eligibility will be reassessed continuously and further medical tests may be required.

Transplant candidacy relies on adequate insurance coverage for your surgery as well as care and medications after discharge. Before a final decision is made, we will request verification of coverage from your insurance provider.

Patients who undergo pancreas transplant, also must have a designated caregiver for assistance after the surgery. This person is needed to help bring you to clinic appointments and help you at home during the first days after leaving the hospital.

Reviewed by health care specialists at UCSF Medical Center.
Last updated February 19, 2009