The pancreas is a small but important organ that produces hormones that maintain stable glucose levels in your bloodstream and convert carbohydrates into usable energy for your body. That is, if you have a working pancreas. For millions of type 1 diabetics, that’s not the case, and we’re tasked with attempting to dose insulin and manage our blood sugar.
A type 1 diabetic’s pancreas no longer produces insulin due to an autoimmune response where a faulty antibody attacks insulin-producing cells in the pancreas. We’re the first to joke about how our pancreas is useless (although that’s not entirely true), while also lamenting our lack of beta cells. Of course, we wish we had insulin-producing pancreases. But most of us don’t plan on getting a new one. While it might seem logical that the best way to treat type 1 diabetes would be a pancreas transplant, most type 1 diabetics don’t pursue it.
Organ transplants are a remarkable example of what modern medicine can achieve. Each year, thousands of people receive successful kidney, liver, and heart transplants. With so many type 1 diabetics around the world, why are pancreas transplants less common than other types of transplants? Couldn’t pancreas transplants cure type 1 diabetes?
The answer is complicated. Pancreas transplants are available, and in recent years, success rates have improved. But donor pancreases are in short supply, and usually only people with extreme complications from diabetes are eligible to receive one. For most type 1 diabetics, the dangers outweigh the benefits, and they don’t pursue a pancreas transplant.
What dangers are involved with a pancreas transplant? Could pancreas transplants become a viable cure for type 1 diabetes in the future? We’ve researched all there is to know about pancreas transplants, and are here to inform you about the risks and future of this procedure.
Pancreas Transplant Risks
A pancreas transplant is a major surgery and comes with serious risks. Beyond the surgery itself, several complications can arise after receiving a transplant. Here are some of the most important risks and complications related to pancreas transplants:
Dangerous surgery
A pancreas transplant involves a complex surgical procedure. Most people receive a simultaneous pancreas-kidney transplant, which has a better success rate than transplanting only the pancreas. Others receive a pancreas and liver transplant. The surgery can take 4-8 hours, and typically requires a week-long stay at the hospital to monitor the patient’s healing and the success of the transplant. Pancreas transplants used to be considered more dangerous than other types of organ transplants, but survival and success rates have improved in recent years.
All major surgeries come with risks like severe bleeding, blood clots, nerve damage, infections, and complications from anesthesia. Doctors usually won’t recommend a pancreas transplant to healthy type 1 diabetics who can control their blood glucose with insulin because it likely won’t improve their life expectancy or their quality of life enough to outweigh the risks of the transplant. Patients also need to wait until a donor pancreas becomes available.
Many people who receive organ transplants will die if they don’t receive a donor organ, or live with an extremely low quality of life. This isn’t the case for most type 1 diabetics, who can live relatively normal lives with insulin therapy. For some people who experience extreme side effects and uncontrollable blood sugar from type 1 diabetes, a pancreas transplant is an option.
Rejection
Another issue with pancreas transplants is the risk of the body rejecting the new pancreas. Even while taking anti-rejection medications, your body can still reject the new organ. Normally, if this starts to happen, doctors will increase the amount of anti-rejection medication. But in some cases, the body’s reaction can cause organ failure. If a transplant fails, it must be removed and the patient has to resume insulin therapy.
Infection
Infections are some of the most common complications from a pancreas transplant. While the results from studies vary, many have found that 70% of people experience infections following a pancreas transplant. Infections are common and treatable, but can quickly become dangerous if left untreated. It’s always a risk, and for someone whose immune system is compromised or is taking immunosuppressants, as is the case for those who get a pancreas transplant, infections can be even more risky. In many cases, deaths related to pancreas transplants are caused by infections.
Immunosuppressants
Everyone who receives a pancreas transplant has to take immunosuppressant medication for the rest of their life. When diabetics are asked why they don’t just get a pancreas transplant, one of the most common answers is that they’d still have to be on medication for the rest of their lives. Most would prefer insulin therapy over immunosuppressants.
That might sound surprising – after all, wouldn’t it be easier to just take a pill every day instead of figuring out insulin dosages and tracking your blood sugar? Although less invasive and time-consuming, immunosuppressants have a lengthy list of side effects. Since the medication suppresses the immune system so that your body doesn’t reject the new pancreas, people who receive a transplant are more prone to infections and sickness. Low immunity means that even common colds and infections can become dangerous, since the body can’t fight them at full strength. Taking immunosuppressants can even increase the risk of developing some types of cancer. People who take immunosuppressants have to be extra cautious to avoid illnesses and injuries, which can increase the stress in their lives.
Cost
A pancreas transplant is an extremely expensive procedure. Costs vary by country, and how much the patient pays depends on whether they have insurance that will partially or fully cover the transplant. But the high cost of a transplant is another reason why it’s not a viable cure for all type 1 diabetics. For someone who can’t get insurance coverage or isn’t wealthy, it’s impossible to afford.
Who Can Receive a Transplant?
That brings us to who is eligible to receive a transplant. Around 1,200 pancreas transplants are performed each year, which is a small number compared with around 10 million people who have type 1 diabetes in the world. In most cases, those who receive pancreas transplants have kidney failure and are also receiving a kidney transplant. Others experience extreme complications due to their type 1 diabetes, which leads to poor quality of life and a risk of premature death. Only type 1 diabetics who are experiencing these severe complications are recommended for pancreas transplants. Without a doctor’s recommendation, it’s almost impossible to get insurance coverage or other types of financial assistance to pay for a transplant.
The number of type 1 diabetics who can receive a pancreas transplant is very limited. Currently, only those who are at the highest risk of dying from diabetes complications can receive a transplant. Only about 70,000 pancreas transplants have ever been performed. There’s a limited supply of donor pancreases, and only people who desperately need them and have access to the surgery have a chance of getting one.
The Future of Pancreas Transplants
Examining all of the risks and challenges, the future of pancreas transplants is unclear. It seems unlikely that this procedure could be used to cure type 1 diabetes on a wide scale. The risks of the procedure and taking immunosuppressants for life, combined with the lack of donor pancreases, make it difficult for the majority of diabetics to receive a transplant.
While pancreas transplants have helped thousands of type 1 diabetics with severe complications, there are many promising potential diabetes cures and effective treatment methods that take precedence. Islet cell transplants and other experimental cures have been proposed as less invasive and less dangerous. Some are working towards cures that won’t require immunosuppressants. At the same time, new technologies are making diabetes management easier and less stressful. Bionic pancreases and closed-loop insulin pumps require less user input, with algorithms that automatically adjust insulin dosage. As diabetes tech improves and progress is made towards a widely accessible cure, pancreas transplants may eventually become obsolete.
Whatever the future holds, here at NJAP, we hope to see scientific breakthroughs in the coming years that benefit all type 1 diabetics and get us closer to a cure. In the meantime, we’ll keep you supplied with stylish CGM patches that help you live your type 1 diabetic life without limits.
Professional Content Writer | LinkedIn | haleighsparks.com
Haleigh has had type 1 diabetes since 2002 and is passionate about the diabetes community and emerging management technologies. She hopes her writing can help and inspire other type 1 diabetics to live their best lives. When she’s not writing, she loves hanging out with her rescue dog, trying new recipes, and traveling the world.
