Recovery at the transplant centre

Most pancreas transplants start working within an hour or so of being implanted. The transplant team will monitor your blood sugars to see how well the pancreas is working. This will tell them when the transplanted pancreas is starting to work.

Most transplanted kidneys start working within a week of the operation. The transplant team will monitor the amount of urine you are making, and your blood results. This will tell them when the transplanted kidney is starting to work.

Patients often go to the intensive care unit after a pancreas transplant. If this is likely to happen, it will be discussed with you before the operation.

For the first 3-5 days after the operation you will be sore around the wound and will require strong painkillers given by injection. Over time, the pain will lessen, and painkilling tablets will be enough.

You may feel sick, so anti-sickness medication may be needed for the first few days.

Pain management

It is important that your pain is well controlled. There are specialist pain teams that can help, if needed.

Good pain control will help you get out of bed earlier, which reduces the risk of blood clots in the legs and lungs. It will also help you take deep breaths and reduce the risk of chest infections. However, painkillers have side effects, including sickness, itching, drowsiness, and constipation.

The nurses and doctors looking after you will keep a close eye on your blood sugars, pulse, blood pressure, temperature and urine output. You will need regular blood tests, as least once daily and sometimes more often.

To start with you’ll need fluid to be given to you through a drip into your vein.

It won’t be long before you can start eating and drinking. This is usually within a day or two of the surgery. The transplant team will see you at least once a day and advise you about this.

Within a day or two you will be helped to sit up in bed and encouraged to start walking. The nurses and physiotherapists will help you. It is very important to get out of bed as soon as possible after your operation to reduce the risk of blood clots in your legs and lungs and other problems after surgery.

You may feel quite bloated after your operation, as it is likely that your bowels will not be working properly for the first few days. Your transplant team will tell you when you can start eating and drinking again. You may need tablets (laxatives) to help you open your bowels. The sooner you get out of bed and start moving around, the sooner your bowels will start working.

If you are still constipated after having laxatives, you may need an enema (a medication given up your anus) to help you open your bowels.

After the first 2-3 days, some of the plastic tubes in your veins and tummy (abdomen) can be removed. Your transplant team will see you and make these decisions.

You will only be discharged from hospital when:

• You are physically strong enough
• Your immunosuppressant medication levels are adequate
• You have learnt enough about your condition to look after yourself at home. This will include information about your medications, knowing how to look for symptoms of rejection or infection, and information about any lifestyle changes you need to make.

Many medicines might be prescribed after a pancreas transplant, for example to prevent rejection or infection, or to manage pain.

All patients that have a transplant will need immunosuppressants. These lower your immune system and reduce the chance of your body rejecting your transplanted pancreas (or kidney).

Each transplant centre unit uses slightly different medication doses and types. Before you leave the transplant centre, you will be given detailed information about your new medications and how to take them. You’ll also be told what other medicines to avoid.

It’s very important that you take all your new medicines as directed.

Learn more about transplant medicines

Please talk to your GP or transplant team before you start taking any over-the-counter medicines or herbal medications. This is because some non-prescription medicines and herbal medications can affect your immunosuppressant medications.

As your transplanted pancreas (or kidney) settles, you should be able to eat more foods. If you were previously on dialysis, you should be able to follow a much less restrictive diet. However, you may need to avoid some foods. Your transplant team will explain you what can and can’t eat.

If you require extra support at home (for example, help with cooking, cleaning, mobility, wound care), this will be discussed with you before you leave hospital.

An appointment will be made for you in the transplant clinic and you’ll be told the date, time, and location of this visit. To start with, most patients will be seen at least twice a week in the transplant clinic after their operation. Hospital transport can be arranged, if needed.

Once the first few months after your operation have passed, it is likely that your pancreas (and kidney) function will be stable, and that you will need to come to the transplant clinic less often. After a year, as long as you do not have any serious problems, most patients only have to attend the centre once every 3 to 6 months.

If you have had a simultaneous pancreas and kidney (SPK) transplant, a tube (stent) is usually inserted between the transplant kidney ureter and your bladder. You will be told when and where this will be removed. This usually happens 3-6 weeks after your transplant.

If you have a dialysis tube (catheter) in your neck or groin veins, you will be told when and where this will be removed. The timing of tube removal depends on how well your kidney transplant is functioning, if you’ve had a simultaneous pancreas and kidney (SPK) transplant