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What Is Pancreas Transplantation?

Pancreas transplantation is surgery that places a healthy donor pancreas into a person whose diabetes can benefit from whole-organ replacement. Most grafts come from deceased donors and include a short segment of donor duodenum attached to the pancreas. The recipient's own pancreas is usually left in place because it can continue providing digestive enzymes even when it no longer produces enough insulin. A functioning donor pancreas can restore endogenous insulin secretion and can eliminate the need for injected insulin in many recipients.

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What Is Pancreas Transplantation?

Pancreas transplantation is surgery that places a healthy donor pancreas into a person whose diabetes can benefit from whole-organ replacement. Most grafts come from deceased donors and include a short segment of donor duodenum attached to the pancreas. The recipient's own pancreas is usually left in place because it can continue providing digestive enzymes even when it no longer produces enough insulin. A functioning donor pancreas can restore endogenous insulin secretion and can eliminate the need for injected insulin in many recipients.

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Why Is Pancreas Transplantation Performed?

The procedure is most commonly used for selected people with type 1 diabetes who have severe complications or glucose instability that cannot be managed adequately with standard treatment. Some carefully selected people with type 2 diabetes or diabetes after pancreatectomy can also qualify when insulin production and resistance characteristics are favorable. Transplant strategies include pancreas transplant alone, simultaneous pancreas-kidney transplantation for patients with kidney failure, and pancreas-after-kidney transplantation. Candidates undergo extensive cardiovascular, vascular, kidney, infection, cancer, metabolic, and psychosocial evaluation because the benefits must outweigh the risks of major surgery and lifelong immunosuppression.

How Is Pancreas Transplantation Performed?

The operation is performed through an abdominal incision under general anesthesia. The donor pancreas and attached donor duodenal segment are placed in the lower abdomen, and the graft blood vessels are connected to the recipient's iliac or other major abdominal vessels. The donor duodenum is commonly connected to the recipient's small intestine so pancreatic digestive secretions drain into the bowel. When a kidney transplant is performed at the same time, the donor kidney is implanted separately in the lower abdomen and connected to the bladder through its ureter.

What Is Recovery Like After Pancreas Transplantation?

Recipients recover in a transplant unit with close monitoring of blood glucose, graft blood flow, kidney function, infection, bleeding, and signs of rejection. A successful pancreas graft can begin producing insulin quickly, allowing many recipients to stop insulin therapy soon after transplantation. Lifelong immunosuppressive medication is required, and blood tests, imaging, glucose measurements, and sometimes pancreas biopsy are used to evaluate graft function. Long-term follow-up also addresses cardiovascular risk, kidney health, medication toxicity, nutrition, exercise, and prevention of infection and malignancy.

What Are the Risks and Complications?

Possible surgical complications include graft thrombosis, bleeding, infection, pancreatitis, bowel leakage, intestinal obstruction, and failure of the donor pancreas. Acute or chronic rejection can damage the graft and can be difficult to detect from symptoms alone. Immunosuppressive medicines increase the risks of infection, kidney injury, high blood pressure, metabolic complications, and certain cancers. Severe thrombosis, uncontrolled infection, rejection, or graft failure can require removal of the transplanted pancreas and return to insulin therapy.

Frequently Asked Questions About Pancreas Transplantation

Is the original pancreas removed during pancreas transplantation?

Usually not. The recipient's pancreas is generally left in place because it still provides digestive enzymes even when its insulin-producing function is inadequate.

What are the main types of pancreas transplantation?

The main strategies are pancreas transplant alone, simultaneous pancreas-kidney transplantation, and pancreas-after-kidney transplantation.

Can a pancreas transplant eliminate the need for insulin?

Yes. A successful graft can restore insulin production and allow many recipients to stop injected insulin, although graft rejection or failure can cause diabetes to return.

Does pancreas transplantation require lifelong immunosuppression?

Yes. Lifelong anti-rejection medication is required to protect the donor pancreas from immune attack.

References

Management of vascular and nonvascular complications following pancreas transplantation with interventional radiology. PubMed. https://pubmed.ncbi.nlm.nih.gov/32089482/. Date Accessed September 11, 2026.

Pancreas transplant. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/pancreas-transplant/about/pac-20384783. Date Accessed September 11, 2026.

Simultaneous pancreas and kidney transplant vs. pancreas after kidney transplantation: is one better? PubMed. https://pubmed.ncbi.nlm.nih.gov/40314358/. Date Accessed September 11, 2026.

The concept of immunothrombosis in pancreas transplantation. PubMed. https://pubmed.ncbi.nlm.nih.gov/39709128/. Date Accessed September 11, 2026.

Risk Factors for Early Pancreatic Allograft Thrombosis Following Simultaneous Pancreas-Kidney Transplantation: A Systematic Review. PubMed. https://pubmed.ncbi.nlm.nih.gov/33052066/. Date Accessed September 11, 2026.