A 37-year-old Sussex County woman who lived on daily insulin shots for more than 20 years is now free of the symptoms of diabetes after becoming the first person to undergo a life-saving Pancreas After Kidney (PAK) transplant surgery in New Jersey.
Barbara Crabtree, of Andover Township, who was diabetic since the age of 13, underwent surgery at Saint Barnabas Medical Center recently and is living a normal life, free of insulin shots, a regulated diet and, most importantly, the threat of long-term damage caused by the disease.
“A lot of people don’t realize how debilitating diabetes can be,” says Mrs. Crabtree. “The difference this is going to make in my life is just amazing. I will be able to really start a career for the first time. Even more than that, I’ll be able to live my life without this burden. I am just so grateful.”
According to the American Diabetes Association, 500,000 to one million people in the United States, have type 1 diabetes, also known as insulin-dependent diabetes mellitus. Type 1 diabetes is an autoimmune disease in which the body does not produce any insulin, a naturally occurring hormone released from the pancreas that regulates the metabolism of glucose. Combined, types 1 and 2 diabetes are the seventh leading cause of death in the country and contribute to numerous other serious medical complications, among them, blindness, kidney disease, heart disease and stroke, nerve damage, and impotence.
Mrs. Crabtree’s health had already been on a decline since 1989 when she experienced kidney failure and was on dialysis for a year and a half waiting to receive a kidney. Another family’s tragedy two years later, in 1991, allowed her a second chance when the family of an 11-year-old killed in a car accident donated their daughter’s kidney. Following surgery, Mrs. Crabtree immediately felt rejuvenated and continued to follow her diet and other medical instructions to live life to the fullest in spite of her diabetes.
However, her health continued to deteriorate due to the long-term effects of her diabetes. She suffered from a diabetic eye disorder known as retinopathy, open ulcers on her feet, high blood pressure, as well as the removal of her spleen and gall bladder before going on the waiting list to receive a pancreas.
Since Mrs. Crabtree’s kidney failure occurred before Simultaneous Pancreas/Kidney (SPK) transplant surgery was available anywhere on the East Coast, and PAK transplantation was not available in New Jersey until 2001, she had little hope of eliminating her diabetes-related symptoms.
But in February 2000, she was put on the pancreas waiting list. After a false alarm on Super Bowl Sunday 2001 (because the pancreas was not a good enough match) Mrs. Crabtree got another call less than a week later. To her amazement, there was a perfect match and in February, she became the first person to undergo the pancreas transplantation procedure in the state.
“Expanding the scope of medical options and improving the quality of life of our patients with End Stage Renal Disease has been our primary goal,” explains Stuart Geffner, M.D., Director of Transplant Surgery for the Saint Barnabas Health Care System. “We are reaching out to those individuals with insulin dependent or type 1 diabetes who had a kidney transplant prior to 1995, as well as those who have had the benefit of a kidney transplant from a living donor. Living donor kidneys typically do extremely well, better than cadaver donations. Patients seeking PAK transplantation are already taking immunosuppressive drugs and tend to do very well following their pancreas transplant.”
Pancreas-only transplantation, currently unavailable in New Jersey, accounts for only a small number of transplants nationwide, and is less successful than PAK and SPK surgery. One reason for its lower success rate is because current immunosuppressive medications can cause kidney dysfunction. PAK patients usually do extremely well because they have already been taking immunosuppressive medications with proven success.
According to The Sharing Network and United Network for Organ Sharing, there were 20 SPK transplants performed in New Jersey in 2000, with 15 pancreases distributed to other states since PAK transplantation was not available at the time. It is hoped in 2001 that these organs will be used here in New Jersey. Last year, 724 SPK transplants were performed nationally and 214 PAK transplants were performed, as opposed to 9,970 kidney transplants across the country.
For Mrs. Crabtree and her husband Arthur, the miracle of organ donation is ever-present on their minds. “In both cases, I received organs from children. To think that these parents, who in their worst hour, had the presence of mind to think to donate is just so amazing to me. I am so grateful to the families of these children and encourage others to educate themselves about organ donation.”
For Mr. Crabtree, the “gift of life” allows he and his wife to live a normal life for the first time ever. “Barbara’s diabetes was getting so severe that it was getting harder and harder to maintain her sugar levels,” he explains. “Although I learned what to do in an emergency, I had to call the Andover Township ambulance squad half a dozen times in the past few months when she was in danger of slipping into a coma. It was frightening. I can’t wait to tell them about the transplant.”
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