Pancreas transplant - Why a pancreas transplant is carried out

A pancreas transplant is mainly used to help treat people with type 1 diabetes.

In type 1 diabetes the body’s own immune system attacks and destroys the cells in the pancreas that produce insulin (the islet cells). Insulin is the hormone used by the body to break down glucose to produce energy.

A lack of insulin causes symptoms of tiredness and frequent urinating, as well as long-term complications, such as kidney disease and eye disease.

If a healthy pancreas is transplanted into the body it should start producing insulin which can help relieve symptoms and prevent complications from occurring or getting worse.

It should be stressed that a pancreas transplant is not a routine treatment for type 1 diabetes. It is a major operation with risks of serious complications. You will also need to take lifelong medication, known as immunosuppressants, which prevent your body's immune system attacking the new pancreas. Immunosuppressants can cause a wide range of side effects.

Read more about the risks of a pancreas transplant.

As most people with type 1 diabetes are able to control their symptoms with insulin injections, in most cases the risks associated with surgery outweigh the potential benefits.

Who should have a transplant

A pancreas transplant is usually only recommended for people with type 1 diabetes who fail to respond to insulin treatment. This usually means they have developed complications or have a high risk of developing them in future.

For example, a transplant may be recommended if:

• you have kidney disease, which can lead to kidney failure – a pancreas transplant is sometimes performed alongside a kidney transplant
• you have frequent and severe episodes of hypoglycaemia (where your blood glucose levels drop to dangerously low levels causing symptoms such as dizziness and mental confusion)

Why you might be unsuitable for a pancreas transplant

The supply of donor pancreases is limited so a transplant will not be considered if it's unlikely to be successful. 

You may be considered unsuitable if:

• you have severe coronary heart disease
• you have recently had a heart attack
• you are very overweight (obese)
• you have a recent history of cancer, because there is a greater chance that the cancer could spread once you are on immunosuppression for the transplant (exceptions can be made for some types of skin cancer as these are unlikely to spread)
• you have a serious mental health or behavioural condition, such as psychosis or bipolar disorder, which means you would be unlikely to be able to comply with the medical recommendations after a pancreas transplant
• you are in a very poor state of health and are unlikely to withstand the effects of surgery or having to take immunosuppressants

Additionally, a pancreas transplant may not be offered if you are:

• abusing alcohol – most transplant centres only consider a person for transplant if they have not drunk alcohol for at least three months
• abusing drugs – most transplant centres would only consider a person for transplant if they attend a drug rehabilitation course and remain free from drugs for at least six months (some transplant centres will accept people who are currently taking the heroin substitute methadone)
• smoking – most transplant centres won't offer a transplant if a person still smokes, as smoking shortens the life of the transplants and makes diabetic vascular disease much worse