Still being a fairly new diabetic, The thought has crossed my mind, why cant they transplant a pancreas and cure a diabetic ?? They seem to do everything else, heart, lungs etc ? Can anyone enlighten me ?
They CAN do pancreas transplants, but you would just be trading one evil for another. Once you have a transplant, you are on anti-rejection meds for life, and they can be really damaging. My best friend had a lung transplant for Primary Pulmonary Hypertension, a disease which destroys the lungs, and the anti-rejection drugs turned her organs into tissue paper, and she died of a perforation of the bowel that was caused merely by stumbling off a step. And before that happened, her kidneys failed and she had to go on dialysis which is REALLY unpleasant as well as time-consuming, and she developed diabetes and had to start taking insulin. The lung transplant DID give her about 4 years of quality life she wouldn’t have otherwise had, but it sure wasn’t a cure, nor did it lead to a happily ever after ending.
Usually, people who get pancreas transplants are those who are also getting kidney transplants because of kidney failure, so they have to be on anti-rejection meds anyway. So that makes sense. But believe me, taking care of diabetes by using insulin is far preferable to anti-rejection meds! When I developed diabetes, my friend was healthy, and I thought I was the unlucky one, but now I know better.
Currently they do some pancreas transplants with a kidney one. I know someone whose husband had both a kidney & pancreas transplant. He had to go back on insulin after about 5 years. If you think about it, since they don’t really know the cause of T1, they need to figure that out before a pancreas transplant can be successful. Whatever killed your pancreas in the first place can just kill it again. I don’t know what the rates are for long-term success of a pancreas transplant, but I know at least one person who only had a temporary reprieve. Plus, you need to take anti-organ rejection meds for the rest of your life. Which is worse, those meds or insulin?
As Natalie and Kelly have pointed out, this is a situation where you would really want to weigh the benefits against the negatives of the procedure, lifelong treatment, and potential negative outcome. Additionally, I would imagine that the donor organ supply is very limited.
There are only 2 reasons they do pancreas transplants. One is if you need a kidney tx (transplant) or have already had one, or if you are so hypoglycemically unaware that you are a danger to yourself and to others. As some of the other posters have said, they won’t give you the seriously potential negative side effects of the anti-rejection drugs if you don’t have complications already. These drugs cause bone loss, anemia, susceptible to infection and all sorts of other things. On the other hand, I was on dialysis for a year and that took a more severe toll on my health than the drugs for my kidney and pancreas. Basically, they won’t give you the almost guaranteed side effects (at least some of them) of the drugs if you don’t have complications already.
Cora
I done the Pancres Transplant in the early 90’swhen it was still very expermental. After 7 different rejection episodes I finally rejected. Natlie is sooooo right about those antirejection meds. When the d came back (after many hospital stayes and all those meds) I was up for another and I told the Drs that I knew how to be a diabetic but not how to be a transplant patent. So I setteled for the d.
Doris, they’ve come a very long way with the pancreas transplants. Average expectancy of the life of the graft is double what it was, and in my case, I’m not even on prednisone (the worst of the drugs). I am 3 1/2 years out and so far have never had an episode of rejection with the pancreas (knock on wood). I’m almost 9 years post with the kidney and no rejection there either. I know one day I’ll have d again, but I can live with going back to my pump.
Cora
OMG Prednisone. GOD HOW I HATED IT! It really affected my mood. Roid rang?? Yep had it. I’m so glad they have come so much farthr than they were back then. Glad ur having a real sucess with it!!! I went back to the pump too.
Thanks so much for the replies everyone, I had just never heard of it and was glad to get all that info, was really interesting to hear from you who have had it done.
the risks in this case do not outweigh the benefits. Like Natalie said, anti-rejection meds can have a lot of side-effects, including a suppressed immune system. Also, if your disease is auto-immune, then it is likely that your body would attack the new functioning beta cells, even if your own stem cells were used to regenerate your pancreas. If medicine can’t determine how to stop the immune system from attacking your cells, then the transplant would only be effective for so long. Sometimes beta cells are transplanted, but this is most effective in cases where the person has hypoglycemic unawareness, for some reason.
Kphil, while this is a popular theory that your body will attack the new pancreas because of the initial autoimmune reponse, it is not how it works in practice. First off, the anti rejection meds prevent the attack. Secondly, many studies are now suggesting that once the initial attack is over, the body relaxes and doesn’t repeat it. Pancreas transplants are working better and better (as are kidneys and livers and other organs) thanks to better drugs. When the organ does fail, it is typically due to regular rejection routes just like with any other transplanted organ. Pancreases (pancrei? lol) don’t last as long because the organ is quite spongy and more prone to damage than a solid organ like a kidney or liver. But the average is almost double what it was 10 years ago.
Cora
I do know someone that had his new pancreas killed by a 2nd autoimmune attack - that is not theory, it actually happened to someone. The problem with autoimmune stuff is many of us have multiple autoimmune problems. The original attack on the pancreas may have stopped but only because there was nothing left of the pancreas to keep attacking.
That’s one person. I know literally dozens of pancreas transplant recipients, some with their organs as long as 15 years or more. Pancreas transplant are not any less successful than any other transplants of delicate type organs (I mean delicate versus a solid organ like a heart or a liver or kidney).
It can work for some. Type 1 is [most often] a disease of your immune system, not your pancreas. Your pancreas was healthy until some of the T-cells in your immune system destroyed it. A transplant is fixing what was destroyed by the disease. As previous posters have already mentioned, for some the transplant process/after medications can actually help stop the autoimmune response. But it’s not guaranteed and the process is tough.
Plural of pancreas is pancreata. Or at least that’s what I read in a medical journal article. 
My kidney dr said they will do both a kidney and pancreas transplant, if you like when they do a kidney transplant. Usually the pancreas isn’t too in demand, so they are easy to come by. He also said that most pancreast transplants don’t take, from what he’s heard, unelss you also have a kidney transplant, and they haven’t figured out why yet. That could be old data, since he’s a kidney guy.
Wow. This is a story I’ve never heard. Thanks for sharing it, Doris.
I think it is old data. My transplant center (U of Minnesota in Minneapolis) does a lot of pancreas txs and some (not most though) are done alone. They do a lot in the overall, well over 150 per year and I think that they get maybe 5 or 6 that don’t take right off the bat. Usually this is due to blood flow problems as the vessels are quite tiny.
I wouldn’t recommend a new pancreas unless you have some significant complications, but I have been enjoying mine.
Cora
There are some excellent transplant centers at selected places throughout the US. Those who have been transplanted generallly are not on boards like this one because they don’t consider themselves people with diabetes any more. Yes, antirejection drugs are multitudinous throughout the day and a pain to line up, ensure you have them, and they put the body in likelihood of catching whatever is around and gaining weight. Now pancreas transplants are lasting over 20 years. Some are going on 22-24 years; while the kidneys are going bad and new kidneys are being transplanted, the transplanted pancreases are still functioning. Since they were all experimental in 1989 and drugs and drug regimens were not as well established, there were many more rejections than now. Different antirejection drugs are now being used and many different other processes with antibodies are being used to prevent rejection. It is something to consider when one is going into end stage kidney disease.
Let’s just hope to god that Dr Faustman’s theory using BCG can actually be sufficient enough to stop the attack on our cells. I have a feeling there will be additional treatment needed but at least she’s trying to stop what’s causing the diabetes in the first place rather then transplanting more cells. I met a woman that had a pancreas transplant and was a type 1. She said it was the best thing she ever did. I can’t remember if she had the Kidney done as well but she said being on insulin was far worse then the Anti rejection meds. Another problem with needing the Anti rejection drugs is the cost. Roughly $30K a year. Who the hell can afford that? I don’t even make $30K a year.