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On the day of the pancreas transplant, the recipient is notified by a doctor of reno-pancreatic transplant team. The person must get to the hospital as quickly as possible for the pancreas transplant to be performed, which is usually accompanied by a kidney transplant.
A surgical team leaves the hospital to go and remove the donor's pancreas. If the team removing the pancreas come across a problem with the donor pancreas, the transplant is cancelled. However, once the donation team gives the go-ahead for the pancreas, the entire process to carry out the transplant starts.
The recipient patient is prepared, a blood sample is taken and analysed and a compatibility test with the donor organ (crossmatch)is done. If the patient needs dialysis, this is done before entering the operating room. The patient is transferred to the operating room once all these tests have been carried out and compatibility has been verified.
Two surgical teams participate in the transplant: surgeons who perform the pancreas transplant and urologists who perform the kidney transplant.
Once the organs are confirmed as suitable for transplantation, the operation coordinating doctor - who is normally the surgeon responsible for the pancreas transplant - contacts the rest of the team. This team is made up of anaesthetists, urologists, nursing staff and the nephrologist on call. The latter is responsible for calling the recipient patient to determine the most appropriate time to start the transplant.
Once everything is prepared, the transplant recipient goes to the operating room, where he is placed under general anaesthetic by the anaesthetist in preparation for the surgery. The pancreas is transplanted first, followed by the kidney transplant. The complete surgical operation usually lasts about 6 hours.
After the pancreas transplant is finished - about half-way through the operation - the surgeon informs the family of progress with the surgery. At the end of the kidney transplant, the urologist provides them with more information.
Once the pancreas and kidney transplant has been completed, the patient is transferred to the ICU. Once vital signs have stabilised, the patient begins to wake up. After regaining consciousness and when he can breathe on his own, the patient is extubated. The recipient patient is accompanied by the anaesthetist and nursing team at all times.
The patient stays in the ICU for 2-3 days to check on his recovery and verify there are no immediate surgical complications that require a second operation. Different medical tests are performed to determine the functioning of the two transplanted organs: the pancreas and kidney. Immunosuppressive treatment is also started to prevent organ rejection.
If there are no problems, the patient is transferred to the hospitalisation room. The Nephrology team will check that renal and pancreatic function are correct. The patient can then eat again, the drains and catheter are removed and he can start to walk. The medication regimen the patient has to follow to prevent organ rejection and possible infections is explained to him. The average time spent in hospital is about 2 weeks.
When the transplant recipient no longer needs medical or nursing support, he is discharged and followed up by the Nephrology Outpatient Clinic and by the renopancreatic transplant team. During these visits, the functioning of the kidney and pancreas and the patient’s health status are checked.