An individual whose pancreas is no longer working normally will receive a healthy pancreas from a dead donor during a pancreas transplant operation. In India, type 1 diabetes is mostly treated via pancreas transplants. This medical problem might be able to be cured with a pancreatic transplantation. However, because a pancreas transplant might have serious adverse effects, it is often only used for persons with severe diabetes problems.
Understanding Pancreas Transplantation
In the belly, next to the stomach, intestines, and other organs, the pancreas is an organ about the size of a hand. It takes up residence in the area in front of the spine and behind the stomach. In addition to producing hormones like insulin and glucagon, the pancreas also secretes digestive fluids that help the body utilise and store food-derived energy.
A healthy pancreas (one that generates insulin) is put into a patient in India who needs a pancreas transplant since their pancreas is no longer producing enough insulin for their body. The whole or partial pancreas from a live donor, or a deceased donor, is used to create the healthy pancreas.
Type 1 or insulin-dependent diabetes may be reversible with pancreatic transplantation. A successful pancreas transplant in India will do away with the need for insulin injections, lessen or do away with the requirement for diabetes-related dietary and physical activity limitations, and decrease or do away with the possibility of life-threatening low blood sugar responses. The potential harm that type 1 diabetes may do to other organs, such as the kidneys, can also be managed with a pancreas transplant.
Kidney impairment is one of Type 1 diabetes’s most dangerous side effects. A large majority of people who qualify for a pancreatic transplant also have renal insufficiency. A kidney transplant in India and a pancreas transplant are commonly carried out together.
With a healthy pancreas from a transplant, a diabetic patient can start producing insulin or achieve insulin independence.
Different Pancreas Transplant Procedures
The following categories apply to different types of pancreas transplants in India:
- Pancreas transplantation alone: Diabetic patients without or with minimal renal impairment may qualify for a pancreas transplant alone. A healthy pancreas is implanted into a recipient whose pancreas is no longer functioning during a pancreatic transplant procedure.
- Combination kidney-pancreas transplant: Surgeons may perform combination kidney-pancreas transplants on diabetic patients who are at danger of renal failure. Most kidney transplants and pancreas transplants are done at the same time. This strategy aims to provide you a healthy kidney and pancreas that are unlikely to cause renal damage caused by diabetes in the future.
- Pancreas after kidney transplant: A kidney transplant may be suggested initially if a living or deceased donor kidney becomes available following a protracted search for both a donor kidney and a donor pancreas. You will have a pancreatic transplant when a donor pancreas becomes available following your recovery from kidney transplant surgery.
- Pancreatic islet cell transplant: During pancreatic islet cell transplant, insulin-producing cells (islet cells) taken from a dead donor’s pancreas are injected into a vein that connects to your liver. It’s probable that transplanted islet cells will need to be injected more than once. Research on islet cell transplantation is being conducted for those with severe, developing type 1 diabetes. Only clinical trials that have been authorised by the Food and Drug Administration may be used for it.
Who in India is the ideal candidate for a pancreas transplant?
Candidates for pancreas transplants in India typically have type 1 diabetes in addition to renal illness, nerve damage, eyesight problems, or some complication of another disease. Patients whose diabetes has advanced despite medical therapy should generally be considered for a transplant. This is particularly true if hypoglycemia has been a chronic problem. Pancreatic transplants have also been performed on people with type 2 diabetes. Additionally, patients without heart or blood vessel disorders had the highest success rates with pancreatic transplants. Before the treatment, you could be encouraged to stop smoking or reduce weight if you opt to have a pancreas transplant.
If one or more of the following circumstances apply, a pancreas transplant in India may be thought of as a potential therapeutic option.
- Type 1 diabetes is not under control with standard therapy.
- Frequently, insulin can cause severe responses.
- A lack of blood sugar control
- a lack of knowledge on hypoglycemia
- Significant Kidney Damage
In India, the cost of a pancreas transplant
In India, a pancreatic transplant typically costs around 18,000 USD. This price can change based on a variety of variables, such as:
Typically, a cadaveric donor is used for the pancreatic implant. For patients from outside India, cadaveric transplantation is not authorised. International patients have the option of receiving a piece of a pancreas that is still functional rather than the entire organ through a live donor pancreas transplant. The donor might be a twin or a close family member.
Procedures for Pancreas Transplantation
#Before the Procedure
You will require the following if your doctor thinks you qualify for a pancreatic transplant in India:
- The first step in getting a pancreatic transplant in India is finding a donor. Cadaveric transplants are not authorised in India for foreign patients. With no other options left, the patient’s only option is a living donor transplant using a twin or other close relative who has a good HLA match.
- The patient won’t get the entire transplanted organ in this sort of procedure.
- In this kind of transplant, the patient will only get a part of the pancreas, which is still functional to some extent.
- The pre-transplant exams can start if the patient is a favourable match for pancreas transplantation.
- You will have blood and urine tests to make sure you are healthy enough to have surgery.
- physical examination and history.
- Immunological evaluations to help the transplant team find a suitable donor for you.
- Your health is checked out using imaging tests like an MRI and ultrasound, which are also used to help plan surgery.
- psychological assessment to make sure you are aware of the hazards and the procedure.
In the days leading up to the transplant, the patient will be required to adhere to a number of instructions, including:
- maintaining a balanced, healthful diet
- giving up drinking and smoking
- Observing the recommended course of therapy
- As advised by your doctor, have an active lifestyle and engage in regular exercise.
- attending every pre-transplant checkup and examination
#Throughout the Procedure
- Depending on the kind of transplant, pancreas transplant surgery might take anywhere between 3 and 6 hours and is performed under general anaesthesia.
- Through an IV intravenous line in the arm, the patient will get all liquid drugs.
- The doctor will cut a deep incision along the middle of your abdomen. The recipient’s lower abdomen will next be implanted with a piece of a donor’s pancreas attached to a piece of the small intestine.
- The blood vessels that supply the recipient’s legs and small intestine with blood will be joined to the donor pancreas and small intestine, respectively.
- The receiver’s pancreas is still present and continues to carry out whatever meagre function it can.
- Finally, the incisions will be closed by the surgeon using stitches. The patient will be sent to an expert recuperation area following the procedure.
#Following after the Procedure
- After stabilising, the patient will be sent to an intensive care unit (ICU), where they will be closely watched for any dangers or issues.
- To make sure the vital organs are working well following the transplant, a few tests will be carried out.
- The patient will regularly receive anti-rejection drugs in order to reduce the risk of acute immunological rejection.
- The patient will be moved to a regular ward after a few days in the ICU, when the initial phase of recovery will start.
- Once the doctor is satisfied that the patient’s condition has been sufficiently stabilised, the patient will be released from the hospital.
#Recovery period following completion of therapy
The prognosis after pancreas transplantation is often good if there are no problems. After surgery, people can survive for many years, if not decades. Nearly 50% of newly implanted pancreases are still functioning after five years. The transplanted pancreas can be removed and replaced if it stops working correctly. You will need to take immunosuppressant medications for the rest of your life after a transplant. They prevent the rejection process, in which your body attacks the new organ, from happening. Despite the fact that certain drugs may have significant side effects, you shouldn’t stop taking them without first talking to your doctor.