How pancreas transplantation is done and when to do it

Pancreatic transplant exists, and is indicated for people with type 1 diabetes who are unable to control blood glucose with insulin or who already have serious complications, such as kidney failure, so that the disease can be controlled and stop the development of complications.

This transplant can cure diabetes by removing or decreasing the need for insulin, however it is indicated in very special cases, as it also presents risks and disadvantages, such as the possibility of complications, such as infections and pancreatitis, in addition to the need to use immunosuppressive drugs for the rest of your life, to avoid rejection of the new pancreas.

When transplantation is indicated

Generally, the indication for pancreas transplantation is done in 3 ways:

• Simultaneous transplantation of pancreas and kidney: indicated for patients with type 1 diabetes with severe chronic renal failure, on dialysis or pre-dialysis phase;
• Pancreatic transplantation after kidney transplantation: indicated for patients with type 1 diabetes who have had a kidney transplant, with current kidney function, to treat the disease more effectively, and avoid other complications such as retinopathy, neuropathy and heart disease, in addition to to avoid new kidney complications;
• Isolated pancreas transplant: indicated for some specific cases of type 1 diabetes, under the guidance of the endocrinologist, for people who, in addition to being at risk for diabetes complications, such as retinopathy, neuropathy, kidney or cardiovascular disease, also have frequent hypoglycemic crises or ketoacidosis, which cause various disorders and complications to the person's health.

It is also possible to have a pancreas transplant in people with type 2 diabetes, when the pancreas is no longer able to produce insulin, and there is kidney failure, but without severe resistance to insulin by the body, which will be determined by the doctor, through examinations.

How the transplant is done

To perform the transplant, the person needs to enter a waiting list, after indication by the endocrinologist, which, in Brazil, takes about 2 to 3 years.

For pancreas transplantation, surgery is performed, which consists of removing the pancreas from the donor, after brain death, and implanting it in the person in need, in a region close to the bladder, without removing the deficient pancreas.

After the procedure, the person may be recovering in the ICU for 1 to 2 days, and then remain hospitalized for about 10 days to assess the organism's reaction, with exams, and to prevent possible complications of the transplant, such as infection, hemorrhage and rejection of the pancreas.

How is recovery

During recovery, you may need to follow some recommendations such as:

• Doing clinical and blood tests, at first, weekly, and over time, it will widen as there is recovery, according to medical advice;
• Use painkillers, antiemetics and other medications prescribed by the doctor, if necessary, to relieve symptoms such as pain and nausea;
• Use immunosuppressive drugs, such as Azathioprine, for example, beginning shortly after transplantation, to prevent the body from trying to reject the new organ.

Although they can cause some side effects, such as nausea, malaise and an increased risk of infections, these drugs are extremely necessary, as the rejection of a transplanted organ can be fatal.

In about 1 to 2 months, the person can gradually return to normal life, as directed by the doctor. After recovery, it is very important to maintain a healthy lifestyle, with a balanced diet and physical activity, as it is very important to maintain good health for the pancreas to function well, in addition to preventing new diseases and even a new diabetes. .

Risks of pancreas transplantation

Although, most of the time, surgery has a great result, there is a risk of some complications due to pancreas transplantation, such as pancreatitis, infection, bleeding or rejection of the pancreas, for example.

However, these risks are reduced by complying with the guidelines of the endocrinologist and the surgeon, before and after surgery, with the performance of exams and the correct use of medicines.

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