How Does Diabetes Impact a Transplant?
When a patient has kidney failure related to type 1 diabetes, a simultaneous kidney-pancreas transplant (SKP) is done, if the physician deems transplant to be the best option for the patient. In type 1 diabetes, the pancreas does not make enough insulin, a hormone that controls the blood sugar level in your body; the transplanted pancreas can make insulin and correct this type of diabetes.
More than 700 SKP transplants are performed annually in the U.S. To get an SKP transplant, a patient must meet the following criteria:
- Be at least 18 years-old
- Have both type 1 diabetes and kidney failure
- Complete a physical and psychological evaluation
Patients that would generally not be considered for an SKP transplant include those who:
- Have cancer
- Do not follow treatment
- Have substance abuse problems
- Have severe mental retardation
- Have severe heart disease and/or severe blood vessel disease
While most patients get both a kidney and pancreas transplant at the same time, the transplants can be done at different times, with the kidney transplant being first.
Type 2 diabetes
Patients with type 2 diabetes are not candidates for an SKP transplant because a pancreas transplant is not needed. In contrast to type 1 diabetes, in type 2, the pancreas makes sufficient insulin, but the body is not able to use the insulin very well.
However, people with type 2 diabetes and kidney failure may still be candidates for a kidney transplant.
Success rate of kidney-pancreas transplants
According to the National Kidney Foundation, the national average for survival rates of kidney-pancreas transplants in adults is 95% still functioning well one year after the operation, and 92.5% at three years. The best results are usually seen when both the pancreas and a kidney come from the same deceased donor as the risk of rejection is significantly reduced.
Rejection is one of the primary risks of an SKP transplant. It is important that the patient is diligent in adhering to prescribed anti-rejection medications and working with the physician to side effects.