Scheduling your transplant
Before you undergo a transplant, we evaluate whether you're an appropriate candidate. Your first clinic visit will begin in the morning with a short orientation and proceed throughout the day. In this first visit, you will be seen by many of the professionals on our transplant team, including a transplant nephrologist, transplant surgeon, social worker, financial coordinator, transplant pharmacist, and dietician.
After your first clinic visit, our transplant team will clearly understand how to proceed with your transplant workup.
A majority of our patients will need additional testing to determine their suitability for transplant surgery. Some tests can be done during your initial visit; others can be done at your local hospital.
Testing & Evaluation
Next, we'll need to perform several pre-transplant tests that will help us determine your overall health status and identify potential problems before they occur. These tests also help us determine if transplantation is your best option.
Joining the waiting list
After completing your testing, your case is presented in a multidisciplinary selection meeting. Your options are discussed by surgeons, nephrologists, nurses, financial coordinators, social workers, and nutritionists. From here, a majority of patients are placed on the waiting list for a cadaveric pancreas donation.
When the time comes for surgery
When a donor pancreas becomes available, the coordinator will call you to get ready. Since this call could come at any time during the day or night, the transplant team should be able to reach you whether you are at home, at school, at work, or on vacation.
Please provide our transplant team with the phone numbers of family members and close friends. Do everything you can to make sure you can be contacted immediately.
When the Phone Call Comes
When that phone call comes, everything will seem like a blur. The coordinator will advise you when to be present at the transplant center. You must move quickly and get to the transplant center without delay. When a pancreas becomes available, there is a time limit!
At the Hospital
After admission, you will have a thorough physical examination, including more blood work, a chest x-ray, an EKG, dialysis, and possibly other tests. Unfortunately, surgery must be postponed in some cases. You will be sent home if:
- You have an infection or have developed any other medical problem that would interfere with surgery or recovery
- The donor pancreas shows signs of deterioration or poor function
If surgery is postponed, the transplant team can help you through the disappointment. This is only a temporary setback, and the search for a new pancreas will continue.
During your transplant surgery
Before entering the operating room, your anesthesiologist will review your medical history. Once they have completed this review, they will give you some medicine to help you relax. You will then be taken into the operating room. Once you're asleep, special I.V.s will be placed to help monitor your status during the surgery. This process takes between 30 and 60 minutes.
After everything has been adequately prepared, your surgeon will begin your surgery. The surgery usually lasts between 2 and 3 hours. The surgery is generally performed through an incision close to your hip bone, measuring between 6 and 12 inches in length, depending on your size and the size of the kidney.
Life after your transplant surgery
If you don't have any complications following your transplant surgery, you should be ready to leave the hospital and head home within about a week. You will receive a schedule of follow-up clinic visits for lab tests and checkups. At these visits, your doctors will track your progress and detect potential complications as early as possible.
You should bring your medication list and surgery handbook to all follow-up visits. You will be given specific instructions for routine lab work or special tests that you might need.
Taking Care of Your New Pancreas
A donated organ is a beautiful gift that deserves to be taken care of. The most critical aspects of post-transplant care are listening to the advice of your doctors and properly taking your immuno-suppression medications. You'll need to take this medication for the rest of your life. This will significantly decrease the chance of rejection episodes, where your immune system attacks the new pancreas.
Modern medical advances — including immunosuppressant drugs that prevent rejection of the new pancreas — make pancreas transplant complications less and less common all the time. Patient and organ survival rates are high, and life expectancy rates are reasonable with the experience of the Intermountain Transplant Center team and your diligent efforts to care for your new pancreas until everyday life is once again possible.
Signs to Watch For
The primary concerns for your new pancreas involve infection and rejection. Your local physician can handle many problems, such as colds or flu, adjustment of your medications, and minor illnesses. You must take precautions and learn to watch for signs of infection and rejection that necessitate immediately notifying a local physician or transplant team. These include:
- A fever that continues for more than two days
- A sudden increase in weight
- Pain, tenderness, or swelling of the new organ
- Ankle swelling
- Decrease in urine output
- Shortness of breath
- Change in glucose control
- Most patients experiencing rejection have no symptoms, and the diagnosis is made solely based on blood tests. There are medications available to treat rejection.