Curing Diabetes

Patients who have received both a pancreas and a kidney have had the best results. Acute rejection is more common, however, than in patients who receive a kidney alone. Surgical complications after pancreas-only transplantation are common, occur earlier, and lead to death in more cases.The most common complications after pancreas transplantation include rejection, infection, venous thrombosis, technical problems with duct anastomosis, and diabetes recurrence. Simultaneous kidney and pancreas transplantation causes more wound complications and a higher incidence of cytomegalovirus infection during the perioperative period than transplantations of the pancreas alone, but simultaneous transplantation poses no other long-term risks.

Hyperglycemia is one indication of rejection, but it doesn’t develop until 90% of the islet cell mass has become compromised, at which point rejection is usually irreversible. One benefit of simultaneous transplantation is that the condition of the transplanted kidney can help the physician predict the likelihood of pancreas rejection.

Up to 30% of transplant patients develop thrombosis of the vessels that supply the pancreas. Sites of surgical anastomosis can leak. After surgery, watch for hematuria related to the kidney vessels and irritation of the duodenal portion of the pancreas graft.

Infection from opportunistic organisms may occur as a complication of immuno suppressive therapy. Fever is a sign of both acute rejection and infection, so if your postoperative patient develops a fever, perform a thorough assessment. Unrecognized rejection can mean the loss of the transplanted organ. Unrecognized infection can lead to systemic inflammatory response syndrome and death.

Filed under: Diabetes Treatment