-
What Is a Pancreas?
The pancreas is a soft, fragile organ, about six inches long that lies deep in the abdomen behind the stomach. The pancreas serves two functions:
1. It releases digestive enzymes and bicarbonate into the first portion of the small intestine called the duodenum. The bicarbonate neutralizes the acid produced in the stomach, while the enzymes break down food into absorbable nutrients.
2. It releases insulin and glucagon into the bloodstream, two hormones that maintain a stable blood level of the sugar glucose.
-
WHAT IS DIABETES?
Diabetes is the condition in which the body cannot regulate the level of glucose in the blood. Type 1 diabetes occurs when the pancreas produces little or no insulin. In type 2 diabetes, the pancreas produces insulin, but the body doesn't respond normally to insulin. In most diabetic patients, the pancreas still produces normal amounts of digestive enzymes.
- Am I a Candidate for Transplant?
If you have been diagnosed with end stage renal disease (ESRD), there is a good chance you are a candidate for a kidney transplant.
People whose end stage renal disease (ESRD) is due to Type I diabetes mellitus may be good candidates for simultaneous kidney-pancreas transplant.
If you have a functioning transplanted kidney and you have Type I diabetes mellitus, you may be a good candidate for pancreas-after-kidney transplant.
Extremely brittle Type I diabetics with significant frequency of hypoglycemic unawareness or episodes of diabetic ketoacidosis, but no ESRD, may be good candidates for pancreas transplant alone.
From Evaluation to Transplant - How Does it All Work?
Either you, your physician or your dialysis unit can contact us at 610-402-8506 to be referred for evaluation to receive a transplant.
Because making an informed decision about transplantation is so important to your success, part of your initial visit to our office includes discussing in detail the benefits and risks of transplantation. After this, we'll conduct a thorough pre-transplant evaluation tailored to your medical history. Throughout the evaluation period, we stay in touch with you to answer questions and address concerns.
Each potential transplant candidate is viewed from a holistic standpoint where transplant is only one aspect of a multifaceted disease process. A well-informed patient has the best opportunity for success following transplantation. Not only will patients learn about the risks and benefits of transplantation from the transplant program staff, but will also be instilled with a sense of responsibility for their own health care. At The Transplant Center, the patient is an integral part of the transplant team.
As a potential transplant candidate, you will go through a pre-transplant evaluation before any recommendations are offered. All potential candidates for transplantation are reviewed by the Transplant Review Board, which has representation from nephrology, surgery, tissue typing, social work, dietary, pharmacy, the transplant coordinators and the financial counselor. The group meets twice monthly to evaluate and discuss those patients going through the pre-transplant evaluation.
Evaluation
To become a candidate for a transplant, an extensive evaluation will be completed before you can be placed on the transplant list or receive a living donor kidney. In addition to meeting with the transplant coordinator and a transplant surgeon, you will undergo testing. Some of the testing includes: blood tests, diagnostic tests, and psychological and social evaluation.
- Blood tests are done to gather information to assist us in evaluating your general health and the health of your kidney, as well as to ensure that you receive a donor organ that is a match for you. Some of the general blood tests you may already be familiar with. They include blood chemistries & clotting studies, such as prothrombin time (PT) and partial thromboplastin time
(PTT) - tests that measure the time it takes for blood to clot. The blood tests that will help determine the best organ match for you may include:
- Your blood type: Each person has a specific blood type: A, B, O or AB. When receiving a transfusion, the blood received must be a compatible type with your own to prevent a serious transfusion reaction. Similarly, the blood group of your organ donor must be compatible to yours to prevent your body from rejecting the organ.
- Tissue Typing, including Human Leukocyte Antigens (HLA) and Panel Reactive Antibody (PRA): These tests help determine the likelihood of success of an organ transplant by checking for antibodies in your blood. Some antibodies in the bloodstream may attack transplanted organs. Therefore, persons who receive a transplant take medications that decrease this rejection response. The higher your PRA, the more difficult it is to obtain a compatible kidney.
- Viral Studies: These tests determine if you have viruses that may increase the likelihood of rejecting the donor organ, or of you developing an infection after transplant. These include cytomegalovirus, HIV, hepatitis, among others.
- Diagnostic tests need to be performed in order to understand your complete medical status and help determine if transplantation is the right option for you. You will undergo a number of diagnostic tests. Several of these are performed on all patients, while others are based on individual factors such as age, sex, past medical history, psychological/social history, physical examination, and results of initial diagnostic tests to determine whether you are a candidate for transplantation.
- The transplant social worker is specially trained to evaluate the mental and social effects of transplantation, as well as the effects of chronic illness on the individual and family. Individual coping skills, stressors and support systems will be reviewed and evaluated to determine if additional resources will be needed. The transplant team will consider all information from interviews, your medical history, psychological/social history, physical examination, and diagnostic tests in determining whether you are a candidate for transplantation.
Transplant List
After your evaluation and acceptance as a candidate for transplant, you will be placed on the appropriate United Network for Organ Sharing (UNOS) waiting list to await your transplant. Or, if you have a living kidney donor, you will be scheduled for a living donor kidney transplant.
