A pancreatic transplantation or pancreas transplantation refers to the surgical procedure, which involves replacing a dysfunctional pancreas with a healthy one.  The donor of the pancreas is usually a deceased person. Pancreas is an important organ of the body as it produces several important hormones, which play a significant role of regulating our body cycles. Pancreas transplantation is usually performed for the treatment of type 1 diabetes which is linked to the inability of the pancreas to produce the insulin hormone.

A pancreatic transplant is considered as one of the potential cures for type 1 diabetes. However it is not considered to be a standard treatment due to complications, such as:

Rejection of graft by the recipient body or similar complications
The medications which are given to prevent the rejection can have serious side effects too
Certain complications like blood clots or infections can occur following the procedure
Failure to control the blood sugar levels and rejection of the graft or complete pancreatic failure are Common complications that occur after a pancreas transplant.
These are the primary reasons why pancreas transplant is often considered to be one of the last measures of treating diabetes. Nevertheless, there are certain conditions where a pancreas transplant is worth considering. Some of the conditions include diabetes which cannot be controlled with the usual treatment procedure, chronic poor blood sugar control, insulin reactions which turns chronic or a serious kidney disease.

Certain medications are also prescribed for anti rejection purposes. These medications need to be taken after the operation for the rest of your life to prevent rejection of the donor graft. These medications can have a few adverse side effects. Some of the side effects include hypertension, thinning of your bones, unwanted weight gain and a rise in your cholesterol levels. Swollen gums or acne are also observed in several cases.  

Often a pancreas transplant is carried out along with a kidney transplant, especially if you have a serious kidney condition. It helps to provide a healthy kidney and a pancreas and also reduces a risk of kidney damage caused due to diabetes later in the future.

Know More About Pancreatic Transplantation!

The diagnosis as well as management of pancreatic cystic lesions is a general problem. Nearly 1% of the patients in the chief medical centers have been observed to have pancreatic cystic lesions on cross sectional imaging. It has also been observed that a quarter of all pancreas scanned in an autopsy series contain pancreatic cysts. Earlier, these cystic lesions were regarded benign but with increasing evidence made available from the cystic lesions, they are regarded as origin of pancreatic malignancies.


Information on asymptomatic neoplastic pancreatic cysts
The most vital medical tools that are used in the diagnosis and management of pancreatic cystic lesions include the endoscopic ultrasound and cross sectional imaging. These are used to distinguish non-mucinous cysts from mucinous cysts. The identification of pancreatic cysts creates a lot of anxiety for the clinicians as well as the patients related to the probable presence of a fatal tumor. The findings of a macro cystic lesion that enclose viscous fluid loaded in cea are helpful in the analysis of a mucinous lesion. 


The most common pancreatic cysts are the non-neoplastic inflammatory pseudo cysts, and they can be detected easily by imaging. The identification of pancreatic irregularity with probable association with malignant cells is a vital source of referral for the specialist. The set of guidelines that have been proposed for the management and diagnosis of patients with asymptomatic neoplastic pancreatic cysts are based specifically on the analysis of the quality of the data. It is also designed to address the most important and frequent clinical scenarios. The diagnostic suggestions are provided based on the clinical problem as well as the risk of malignancy.


Imperative guidelines to follow
To achieve accurate diagnosis of asymptomatic neoplastic pancreatic cysts is indeed a great challenge. It is all the more important to find the reproducible methods that can be used to stratify threat of cancer for the patients. The main guidelines include a two year screening interval of cysts that can be of any size as well as stopping observation after 5 years, in case there is no change. The new guidelines, for the most part, recommend surgery if more than one concerning feature is confirmed on the mri by use of endoscopic ultrasound. The new guidelines even suggest discontinuation of inspection after the surgery if no dysplasia or invasive cancer is identified. The guidelines have mainly been developed by use of grading of recomendations assessment, development and evaluation.

Diagnosis and Management of Asymptomatic Neoplastic Pancreatic Cysts

Pancreas are a small, but a pretty important part of a person s digestive system. So when it needs to be removed, the reason has got to be quite serious, to say the least, doesn t it? The procedure is known formally as a pancreatectomy and it is most often required for people who are suffering from cancer of the pancreas. Ideally, these people would only need the cancerous tumours removed, but things are not always this simple. As a matter of fact, only a little more than a tenth of the people who have pancreatic cancer can have the tumour alone removed. As a result, most need to go for a pancreatectomy, which involves removing the entire pancreas. Whether the pancreas can be kept is usually related to how soon the cancer was detected, with people who have done so in time being a majority of the 10% of people with pancreatic cancer who have not needed pancreatectomies.

If a person does not have cancer, the reason he or she may need a pancreatectomy due to an accident which has injured the area significantly badly. In this case, a procedure which is known as a partial pancreatectomy is carried out on the patient. The good news is that the success rate of this sort of operation is generally quite high and the long-term effects on the body are nil. This is the case in spite of a lot of the normal tissue of the pancreas being removed, pretty amazing, isn t it?

While it may be called a pancreatectomy, it does not always mean that the pancreas is the only thing that is removed. In fact, in a lot of pancreatectomies, the surgeons also remove other parts of the digestive system which are usually the common bile duct, the spleen and the gallbladder.

There is, of course, the case of chronic pancreatitis, which occurs when the organ just swells up repeatedly. The repeated swelling leads to permanent damage of it, which affects the rest of the body, too. In most cases, the cause of this happens to be a sustained addiction to alcohol. When this is the case, it is really hard to perform a pancreatectomy and the utility of the pancreas is greatly reduced. Not a good situation to be in, under any circumstances, at all!

A pancreatectomy is a process which nobody would voluntarily wish to undergo, but there are advantages to knowing what it is, in any case!

Pancreatectomy - When To Go For It?

Diabetes which was earlier called a lazy person's disease does not live up to the name anymore. Owing to the sedentary lifestyle and bad eating habits, diabetes has become an epidemic in the recent years.
As as we all know, diabetes is a condition characterized by an increased concentration of blood glucose level. If not managed and treated on time, the condition can prove to be life threatening. Diabetes is known to trigger a host of health complications and disorders including cancer. In fact, research has established that there is a link between diabetes and pancreatic cancer. The report suggests that people with chronic diabetes for more than 5 years stand at an increased risk of suffering from pancreatic cancer. In some patients, diabetes may be one of the symptoms associated with pancreatic cancer. Whether diabetes triggered pancreatic cancer or was it the precancerous cells that caused the diabetes is difficult to explain.

The pancreas is an important organ involved in the production and secretion of many important hormones including the insulin (by the Beta cells of the pancreas). A diseased condition, such as pancreatic cancer may bring about changes, affecting the proper functioning of the pancreas. This, in turn, may interfere with the production of insulin. Decreased production of insulin or insulin resistance may result in elevated concentrations of glucose in the blood, a condition that will eventually give rise to Diabetes.

According to another published article (NCBI), in many patients with pancreatic cancer, diabetes was detected almost simultaneously along with cancer or 2 years prior to the diagnosis of cancer. These findings indicate the fact that both diabetes and pancreatic cancer not only occurred concomitantly but were also correlated.

Another experiment suggested that in people with Type-2 diabetes, the pancreas was for long subjected to a condition termed as hyperinsulinemia (increased level of insulin in the blood as compared to the blood glucose level). The experiment shows that insulin does have a role to play in establishing a relationship between diabetes and pancreatic cancer.

Managing Diabetes and Pancreatic Cancer
The conditions of diabetes and pancreatic cancer should be managed well to avoid further complications.

The diet plays a significant role in the proper management. The diet should be well balanced with all the essential nutrients. Include more fruits and vegetables in the diet. Berries such as raspberries, blackberries can go a long way to regularize the blood glucose level. Opt for whole grain cereals and food items. Avoid foods rich in fats and carbohydrates.
A healthy body weight can work wonders, both in the case of diabetes and pancreatic cancer. If you are a couch potato, give up the habit at the earliest. Indulge in more physical activities (not necessarily rigorous or strenuous) such as exercise, jogging, morning walk. In addition to keeping your weight in check, these physical activities are excellent stress busters.
The unhealthy lifestyle habits such as drinking, smoking, substance abuse can harm your body beyond imagination. Give up these unhealthy habits as early as you can.
There may be a strong connection between pancreatic cancer and diabetes. However, to avoid one affecting the other, one should take care of themselves and manage the conditions well.

Pancreatic Cancer - Are Diabetic Patients At A Higher Risk?

Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

Pancreas Transplant is a surgical procedure where the damaged pancreas is taken out of the body of the patient and transplanted with the healthy ones from the donor s body.
The pancreas is located in the middle part of the body that helps in the secretion of insulin in the body. Insulin helps in the absorption of sugar in the body and helps in maintaining glucose level. If the pancreas is not producing insulin in sufficient quantity than the patient is likely to suffer type 1 diabetes.

Most of the pancreas transplants are done to cure the extreme conditions of type 1 diabetes. However, the transplants are done only in case of severe diabetic conditions because the pancreas transplant has serious side effects and not always pleasant after surgery recovery.

Why is the Pancreas Transplant Done?
There are several reasons for doctors choosing for pancreas transplantation. One of the most reason is the type of diabetes. However, they are also performed along with the kidney transplantation, when damage to the kidney is done by diabetes.

Following reasons are worth considering for pancreas transplantation:
  Extreme and severe type 1 diabetes
  Kidney damage
  Type 2 diabetes due to a lower level of insulin usage in the body
  Poor blood sugar level

Types of Pancreas Transplantations-

  Pancreas Transplant Alone: The pancreas transplantation is done solely for the diabetic patient whose kidney is unaffected and does not require any surgery along with pancreas transplant.

  Pancreas Transplantation Along with Kidney Transplant: This kind of surgery is done by the doctors when the patient has weak kidney and damaged pancreas. In such a scenario, only kidney transplantation is not sufficient and requires new pancreas for overall development.

  Pancreas-after-kidney Transplantation: For patients who have been waiting long enough for a donor for pancreas and kidney both, this is a better solution. Since the waiting list to get, such donor is long and not probable. Doctors prioritize and perform kidney transplantation first since the condition for kidney transplantation is rather severe and affected. Then after pancreas transplantation is done when a suitable donor is found.

  Pancreatic Islet Cell Transplant: Pancreatic islet cells are responsible for producing insulin into the body. So, doctors perform surgery on the patient and inject the pancreatic islet cells from donor s pancreas to the patient under operation.

Complications of the Procedure-
Some of the common complications of the procedure are:

  Blood clots
  Bleeding
  Infection
  Excess sugar in the blood
  Failure of the donated pancreas
  Transplant rejection
  Urinary tract complications

Conclusion-
Pancreas Transplant is done when the patient is severely diabetic and is not curable with only medication. The doctors suggest the post-surgery rest. The patient is required to be hospitalized for one week at least and keep strict follow-up routine to look after the effects of transplantation.

Pancreas Transplant - When Is It Required?

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