Being admitted to the transplant centre

Information will be given to you about when you should stop eating and drinking. It’s very important that your stomach is empty before the operation. Having an empty stomach helps reduce the risk of vomiting that might cause damage to your lungs when you are asleep.

Blood tests will be taken, and your pulse, blood pressure and temperature will be checked.

If you have had any infections, surgery or blood transfusions in the previous three months, please tell the team. If you have kidney disease, the team looking after you will help decide whether you need dialysis before the transplant operation. You may need other tests as well, for example a heart tracing (electrocardiogram – ECG) or chest X-ray. 

If the transplant team think that you may not be fit enough for a transplant operation, they will discuss this with you.

The anaesthetist will check that you’re fit enough for a general anaesthetic. A general anaesthetic means that you will be completely asleep during the operation. The anaesthetist will tell you about the drips and tubes that you will need, and the benefits and risks of these. They’ll also tell you how your pain will be controlled after the operation.

If you’ve had any problems with anaesthetics before, it’s important that you tell them. If members of your family have had serious reactions to anaesthetics, please tell your anaesthetist.

Your transplant team will speak to you in detail about the benefits and risks of having a pancreas transplant. They will be able to tell you some medical information about your deceased donor, including possible health risks.

Every donor and every pancreas is different. Some donated pancreases are healthier than others. Your transplant team will discuss this with you.

Learn about how the health of your donor can affect the donated pancreas

The pancreas transplant team will tell you how similar your tissue type is to the donor’s (HLA mismatch). You will be told whether the risks of you rejecting this pancreas are higher or lower than average. Rejection happens when your body’s immune system recognises the pancreas transplant as being ‘foreign’ and starts to attack (‘reject’) it.

If your transplant team think that the risk of rejection is high, they may recommend stronger immunosuppressant (anti-rejection) medicines. They will explain the benefits and risks of this.

There are many different ways that a pancreas can be transplanted. The surgical team caring for you will explain their preferred technique, and which would be best for you.

Learn more about pancreas transplant surgery

Once the pancreas arrives at the transplant centre, transplant surgeons will inspect it to make sure that it’s suitable for transplantation.

If your blood or other tests detect that you have a new, serious health problem, the transplant may be too risky to do.

Sometimes the tests can raise concerns about cancer or serious infection in the donor that weren’t known about at the time that the organ offer was accepted.

The transplant cannot go ahead if you have large amounts of antibodies in your blood as this would mean that the organ would be rejected very quickly. Tests will be done before the transplant to see if you have antibodies in your blood against different tissue types. This usually means a cross-match test is needed.

A cross-match test is where your blood is mixed with a sample of the donor’s blood or tissue. This tests whether you have antibodies in your blood that would attack (reject) the donor organ. If you have a lot of antibodies in your blood at the time of the transplant, it is very likely that your body would start to reject the organ within minutes of the transplant. This type of rejection cannot be treated. Therefore, a positive cross-match test means that the transplant cannot go ahead.

Transplant surgeons inspect the donated organ when it arrives to make sure it is safe enough to use. Sometimes organs cannot be used.

Possible problems with donated pancreases include scars, fattiness, lumps, damage to the pancreas when it was removed, or hardening of the arteries supplying the pancreas.

Possible problems with donated kidneys include scars, lumps, damage to the kidney when it was removed, or hardening of the arteries supplying the kidney. Sometimes the kidney cannot be fully flushed with cold preservation fluid, leading to tiny blood clots within the small blood vessels inside the kidney.

Even though a pancreas transplant is a priority operation, if there are sudden life-threatening emergencies in other patients, they may need to be taken to theatre before you. If these operations take a long time, the pancreas (or kidney) meant for you might no longer be safe to transplant.

This very rarely happens in the UK. Your transplant team will be doing everything they can to get your transplant done, but sometimes this is not possible. The transplant team will explain in detail why this happened and what your options are.

Some donors have not been diagnosed as dead at the time that you are called into hospital (DCD – donation after circulatory death donors). These donors are expected to die within hours of their treatment being stopped, and so an organ retrieval team is standing by in the donor's hospital at the time of treatment withdrawal. Sometimes, these donors take many hours or even days to die.  In these circumstances, it is not possible for the retrieval team to stay on site indefinitely.

There are also occasions where a donor has reached the end of their life and is still receiving life-sustaining treatment. The retrieval team is alerted, but sometimes the donor becomes unstable and dies before the retrieval team arrives at the donor hospital. This may mean that the organs become unusable.

Another reason is that circumstances for the donor family may change and they may choose to withdraw their consent/authorisation before the donor is moved to the operating theatre.  While this is rare, we will respect the decisions of the donor family.