Outcomes

Pancreas Transplant May Improve Quality of Life and Reverse Some Secondary Complications of Diabetes

A number of studies published in peer reviewed scientific journals have suggested that neuropathy, kidney disease, circulation, metabolism, and quality of life does improve following a pancreas transplant.  Dr. William Kennedy, a Professor in the Neurology Department at the University of Minnesota, showed that nerve conduction velocity and muscle action potential improved after a pancreas transplant.  Only half of people who have autonomic diabetic neuropathy survived five years, yet he showed that 85% of people who receive pancreas transplants are still living five years later. 

In a 1998 article in the New England Journal of Medicine, Dr. Michael Mauer from the University of Minnesota illustrated that a successful pancreas transplant reverses some of the secondary complications of diabetes.  He studied eight patients who received a pancreas transplant who has mild to advanced kidney lesions from nephropathy.  He did kidney biopsies before the transplant and 5 and 10 years after the transplant.  After 10 years, the kidney lesions had reversed.

Kidney Transplant vs. Pancreas Kidney Transplant

Most diabetic people who need a kidney transplant choose to also have a pancreas transplant.  Patients who have an organ transplant have to take immunosuppressive medications for life to keep their body from rejecting the new organ.  By having both a pancreas and kidney transplanted, patients prevent the recurrence of diabetic kidney disease.  Studies show that diabetic patients that receive both a pancreas and a kidney do better long-term than diabetic patients who receive a kidney transplant.  About 86% of recipients of kidney pancreas transplants studied were still alive eight years after transplant.  This compares with 47% of diabetic patients that received just a kidney transplant.

Preemptive Pancreas Transplant Alone

People who have diabetes are becoming increasingly aware of the long-term issues associated with this disease and are starting to think more proactively about the future of their health.  Dr. Mauer's work illustrated that people who are diabetic and have a predisposition for diabetic kidney disease may want to get a pancreas transplant alone before the deterioration of their kidneys becomes irreversible.  Currently, only about one-third of people who are on the waiting list for a kidney transplant will receive one.  Many of these people are on dialysis.  However, a person with diabetes who is on dialysis has less than a 50% chance of surviving for 2 years.  Few of these people survive for more than 5 years.

Living Donor Transplants Decrease Wait Times & Yield Better Outcomes

For pancreas transplants, the organs may originate either from a deceased-donor or living donor, or a combination of the two. It is not unusual for patients needing both a kidney and pancreas transplant to get the kidney transplant from a living donor, and then wait for a deceased-donor pancreas or have one simultaneously.  By doing so, these patients are reducing the risk associated with waiting for a kidney from a deceased donor; approximately 40% of people on the kidney waiting list nationwide die before they receive an organ.  In addition, transplant outcomes are generally better for people who have received a kidney from a living donor compared with one from a deceased donor.