In the US, about 1,367 pancreas transplantation operations are done each year. The vast majority of these are done in conjunction with a kidney transplantation in patients with Type 1 diabetes who have renal failure. The reason for doing both operations is that if the pancreas transplant is successful, blood glucose will be controlled normally, and the transplanted kidney will be spared the bad effects of high blood sugar. In some medical centers, pancreas transplant grafts in such patients survive for one year in most of patients.

However, pancreas transplants in patients who do not have kidney failure is performed much less commonly. As of 1997 a little more than 100 pancreas transplants had been done in such patients. This was because the success rate had been poor, with only half of the transplants lasting 5 years. More recently, the pancreas transplant graft survival has risen to almost 73% at one year. This improvement is due to better medications to prevent rejection of the pancreas transplant, lower risk of infection, and better surgery. Still, most centers are very cautious about recommending a pancreas transplant to a patient who does not also have kidney failure. Most centers will consider pancreas transplant only if the patient cannot control glucose well and if there is clear evidence of significant kidney impairment by blood tests, urine tests and kidney biopsy examination. Even then, pancreas transplantion carries the risks of the operation itself, and after surgery patients must take powerful medications to prevent rejection. These medications carry significant risks and side effects including death and developing cancer. The drugs that prevent rejection may be harmful to kidney function.

I would advise all potential candidates for pancreas transplant to speak with their primary care physician or diabetologist about this procedure, and to approach it with caution. If it is a serious consideration, I would recommend a consultation at one of the few major medical centers who are doing the procedure regularly. Your local chapter of the American Diabetes Association can help you identify those centers. I hope this helps you. I wish you good health.

Dr. Bruce Biller

-- Dr. Bruce Biller is an internist with subspecialty training in endocrinology and a special interest in diabetes. He is director of the Harvard Business School Health Services and physician to the Harvard University Health Services.

First published May 1, 2003
Last updated February 11, 2008
Copyright © 2003 Consumer Health Interactive