Pancreas Transplant

Transplantation

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Pancreas transplantation is an option for some patients with type 1 diabetes, as it restores the body's ability to control blood sugar levels and allows most patients to stop using insulin. Pancreas transplantation sometimes slows the progression of diabetes or reverses the secondary complications such as retinopathy and neuropathy. When kidney transplantation is performed at the same time, the transplanted pancreas protects the new kidney from damage caused by diabetes.

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Pancreas Transplantation at NewYork-Presbyterian

The northeast region of the U.S. has historically had relatively few pancreas transplantation centers that each serve a large population. Over the past several years NewYork-Presbyterian has expanded its program and now treats many patients with diabetes in the New York metropolitan area, particularly those with the most complex medical and surgical challenges.

Surgeons at NewYork-Presbyterian/Weill Cornell Medical Center have performed pancreas transplants since 1996, and those at NewYork-Presbyterian/Columbia University Medical Center, have performed pancreas transplants since 2008. Both centers also maintain active programs in metabolic surgery, a promising procedure for reversing type 2 diabetes.

Islet Cell Transplantation

Transplantation of pancreatic islet cells into patients with type 1 diabetes may reverse the disease without the need for major surgery. In this procedure, islet cells obtained from the pancreas of one or two deceased donors are infused via catheter into the recipient's liver, where they act as a back-up pancreas, producing insulin and regulating blood sugar. When this is performed with the patient's own cells (autotransplantation), the success is very high, and such patients avoid developing diabetes after pancreatic resection. This contributes significantly to their long-term prognosis.

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NewYork-Presbyterian is a center of research and expertise in islet cell transplantation to treat type 1 diabetes. The first successful islet cell transplant in the New York Tri-State area was performed at NewYork-Presbyterian/Weill Cornell. However, islet cell transplantation is still in the research phase, and much more work is needed to determine whether it is a suitable option for patients with Type 1 diabetes.

Candidates for Pancreas Transplantation

Pancreas transplantation is an important option for certain patients. Doctors usually recommend the procedure when patients with diabetes mellitus also have imminent or established end-stage renal disease, have had or plan to have a kidney transplant, and also meet the following criteria:

A history of frequent acute severe metabolic complications requiring medical attention such as hypoglycemia, hyperglycemia, ketoacidosis.
Incapacitating clinical and emotional problems associated with insulin therapy.
Consistent failure of insulin-based management to prevent acute or chronic complications.

Patients with type 1 diabetes and hypoglycemic unawareness (lack of ability to sense when blood glucose is low) may be candidates for pancreas transplantation regardless of whether or not they need kidney transplantation and despite the potential complications of immunosuppression. In such cases, pancreas transplantation may remove the need for insulin injections and may protect the native kidney.

A small subset of patients with type 2 diabetes may also be candidates for pancreas transplantation.