Who is able to have a pancreas transplant?

A pancreas transplant is a treatment option for a small number of people with insulin-treated diabetes

Key points

A pancreas transplant is an option for some patients with insulin-treated diabetes
A pancreas transplant is a major operation and comes with risks
Other treatments may be better for some patients
Talk to your pancreas doctor about the right treatment for you

Who can have a pancreas transplant?

A pancreas transplant is a treatment option for some patients who have major complications from their diabetes. This includes kidney failure or serious problems with low blood sugars (‘hypos’). Most patients with insulin-treated diabetes do not need a pancreas transplant.

To have a pancreas transplant:

You must have insulin-treated diabetes
You must be experiencing major complications from your diabetes
You must be well enough to cope with major surgery
The transplant needs to have a good chance of success
You must be able to take the required daily medicines after a transplant, including immunosuppressant medicines

Why might you need a transplant?

You have insulin-treated diabetes and kidney failure

If you have insulin-treated diabetes and kidney failure, you may be suitable for a transplant. There are a few different options:

1. A combined kidney and pancreas transplant. This is known as Simultaneous Pancreas-Kidney (SPK) transplant. This is the most common type of pancreas transplant.

2. A kidney transplant by itself. There are different types of kidney donor (living donor or deceased donor). If your kidney function is reducing only slowly, it may be possible for you to receive a kidney transplant before you need dialysis (‘pre-emptive transplantation’). This has many advantages for you and your health. However, many patients need to go on dialysis while they wait for a kidney, particularly if they do not have a living donor.

Learn more about receiving a kidney

3. A kidney transplant, followed by a pancreas transplant a year or so later. This is known as a Pancreas After Kidney (PAK) transplant. This is an option for patients who have a living kidney donor, but still wish to be free of insulin injections.

Learn more about living kidney donation

4. Some patients with insulin-treated diabetes and kidney failure might be suitable for Simultaneous Islet and Kidney (SIK) transplantation. This is where the insulin-producing cells (islets) of a donated pancreas are separated from the rest of the pancreas tissue. The islets are placed into the veins within your liver through a narrow tube. Surgery is shorter than SPK transplantation and the risks of complications after surgery are lower.

Your insulin-treated diabetes is hard to control

If you experience frequent episodes of low blood sugars (‘hypos’) that need the help of other people, your insulin-treated diabetes is not well-controlled.

This may be the case with people with diabetes who are unaware that they are having a 'hypo', but other people do notice it.

Some patients in this group may be suitable for a pancreas transplant by itself. This is known as a PTA transplant - Pancreas Transplant Alone).

Alternatively, an islet transplant might be an option. This is where the insulin-producing cells (islets) of a donated pancreas are separated from the rest of the pancreas tissue. The islets are injected into the veins within your liver through a narrow tube. Surgery is shorter than pancreas transplantation and the risks of complications after surgery are lower.

You have insulin-treated diabetes and have had a kidney transplant

Sometimes, these patients may be suitable for a Pancreas After Kidney transplant. This is known as a PAK transplant.

Alternatively, an islet transplant might be an option. This is where the insulin-producing cells (islets) of a donated pancreas are separated from the rest of the pancreas tissue. The islets are placed into the veins within your liver through a narrow tube. Surgery is shorter than pancreas transplantation and the risks of complications after surgery are lower.

Why a pancreas transplant might not be your best option

A pancreas transplant has lots of advantages but it also has some disadvantages, which may make it too risky for some patients.

The main disadvantages are:

A pancreas transplant is a major operation lasting 2-4 hours
If a kidney is transplanted at the same time as a pancreas (an SPK transplant), the operation can take 4-8 hours
The surgery can place a strain on your heart or lungs
You have to take powerful immunosuppressant medicines afterwards, which can lead to other serious medical problems
Some patients experience psychological difficulties afterwards

Learn more about the risks of a pancreas transplant

Other options to a pancreas transplant

Most patients with insulin-treated diabetes do not need a pancreas transplant. For others, a pancreas transplant may be too risky. For these patients, there are other options.

What’s the safest option for you?