The Renal and Pancreas Transplant Division offers the option of pancreas
transplantation to patients who suffer from insulin dependent, type I
diabetes mellitus. At the present time, pancreas transplantation is performed
only if a diabetic patient also suffers from kidney failure. The Saint
Barnabas Renal and Pancreas Transplant Division offers two programs.
Pancreas After Kidney (PAK) transplantation allows patients to receive a kidney transplant as their
first choice of therapy if a suitable living kidney donor is available.
This process may be preferable given the high long-term success rate of
living kidney transplantation and the relatively long wait for a cadaveric
kidney. Patients are then offered the option of pancreas transplantation
after successful kidney transplantation.
If a patient has already undergone kidney transplantation, either through
living or cadaveric donation, he/she can be evaluated for PAK.
Simultaneous Pancreas/Kidney (SPK) transplantation may be the procedure of choice in the event that the patient
does not have a living kidney donor available.
As per our protocol and policy, the following criteria have been established
for recipient selection.
- Have type I (juvenile) diabetes as the underlying disease
- Have evidence of kidney failure
- Be less than 50 years old
- Have had minimal abdominal surgery
- Be free of advanced secondary complications of diabetes, such as blindness,
amputation, or severe vascular disease
Patients are eligible before beginning dialysis or while on hemo or peritoneal dialysis.
Proposed Benefits of PAK or SPK Transplantation
- Kidney transplantation will eliminate the need for dialysis
- Pancreas transplantation will control the blood sugar in the recipient
- Patients will have no need for insulin following a successful PAK or SPK
- Patients will have no dietary restrictions
- A transplanted pancreas can delay, prevent, or in some cases, improve the
secondary complications of diabetes
- Patients will experience a significant improvement in their quality of life
The Evaluation Process
All potential recipients will first undergo the standard pre-transplant
medical evaluation. Once it is determined that the patient may be a suitable
pancreas transplant candidate, the patient will be referred to the Director
of Transplant Surgery for further evaluation. Additional testing may be
required at this point.
If a voluntary, suitable living kidney donor is identified, then an appropriate
donor evaluation will be performed. In this instance, the patient would
then undergo kidney transplantation first and PAK transplantation afterwards.
All potential pancreas candidates will be referred to the Director of
Transplant Surgery for evaluation for either SPK or PAK.
When the entire evaluation and testing process is complete, a determination
will be made whether to place the patient on the SPK waiting list or the
cadaveric kidney waiting list, or to perform a living kidney donor transplantation
followed by PAK transplantation, if the patient is eligible. These lists
are separate; a patient may be placed on only one of these three lists.
When Organs Become Available
When potential organs become available, the patient with the best match
and most points on the list is notified by the transplant coordinator.
The potential recipient will receive further instructions from the transplant
coordinator on how to prepare for surgery.
After the transplant, the recipient is admitted to the intensive care unit
(ICU). Most patients remain in the ICU for two to three days. Recipients
will then be transferred to the specialized Renal and Transplant Unit.
Function of the transplanted organ(s) will be closely monitored with laboratory
and x-ray studies. The total hospital stay is approximately 10 days.
Following discharge from the hospital, medications that prevent certain
types of infection, as well as rejection of the transplanted organ(s),
will have to be taken. During the hospital stay, the transplant case manager
provides education about these medications. Blood work, taken several
times per week, enables the doctor to monitor the continued function of
the transplanted organs. Follow-up clinic visits will be scheduled on
a regular basis. With successful SPK or PAK transplantation, patients
can expect to be free of insulin and dialysis.
It is our hope that patients will begin to enjoy a vastly improved quality
of life following a successful pancreas transplant. To be considered for
placement onto the SPK or PAK waiting lists, please contact the Saint
Barnabas Renal and Pancreas Transplant Center for an appointment.
Important Phone Numbers
Newark Beth Israel Medical Center: 1-877-878-7555
Saint Barnabas Medical Center: 1-888-409-4707
Saint Barnabas: Theresa Belica, RN, 973-322-5963
Newark Beth: Jennifer Hinkis, RN, BSN, CCTC, 973-926-7568
Transplant Social Worker
Saint Barnabas: Marcia Krupit, LCSW, 973-322-8461
Newark Beth: Adriane Shaw, MSW, 972-926-3537
Saint Barnabas: Vickie Henderson-Hicks, 973-322-8998
Newark Beth: Pamela Drayton, 973-926-7263
Transplant Administrative Director
Debra Morgan, 973-322-8988