Explore This Treatment

icon showing high importanceThe Pancreas Transplant Program at Mass General Transplant Center is temporarily paused. Active pre-transplant pancreas candidates are being supported by our local transplant colleagues. We are working to resume services soon. Thank you for your understanding.


About the Pancreas Transplant Program

A regional leader in pancreas and islet transplantation, Massachusetts General Hospital continues to achieve some of the best outcomes in pancreas transplantation in the country. We are also one of the few centers in the country to offer islet transplantation, a pioneering, minimally invasive technique that replaces the insulin producing cells of the pancreas with less surgical risk and a shorter recovery time than a whole organ transplant.

For patients who require a pancreas or islet transplant, we offer convenient access to both procedures, as well as the ease and reassurance of receiving comprehensive, innovative care at one center.

A Leader in Islet Transplantation

The Mass General islet team is part of the multicenter Clinical Islet Transplantation Consortium (CIT), dedicated to advancing the technique of islet transplantation. We also operate the only active FDA-approved facility for the isolation and preparation of islets for human transplantation.

Patients with type 1 diabetes who are not candidates for whole organ pancreas transplantation may be eligible to undergo islet transplantation through a clinical trial currently underway at our Transplant Center.

Mass General has also initiated an islet auto transplant program for patients with chronic pancreatitis, in which patients requiring surgical removal of their pancreas have the insulin-producing islets isolated from the removed pancreas and replaced in the patient’s body to prevent the development of diabetes.

Transplant Evaluation

All patients receive integrated, comprehensive care to treat their diabetes, beginning with a careful assessment and discussion with the patient to ensure that transplantation is his/her best treatment option. Candidates work with a transplant coordinator, who participates in the initial evaluation, gathers medical information and previous test results, and manages the patient’s full evaluation, which includes patient education, medical, surgical and psychosocial evaluation, and transplant-specific testing.

Learn about pre-transplant evaluation

To begin the pancreas transplant evaluation process, you must first be referred to the Mass General Pancreas Transplant Clinic by your primary care physician or endocrinologist. A pancreas transplant nurse coordinator along with a transplant surgeon will review your referral and medical records once they have been received. Transplant Center staff will then schedule an initial evaluation appointment. If you are also a candidate for kidney transplantation, you will be evaluated for both transplants at the same time.

Depending on the number of tests required for each patient, the length of the evaluation process can vary, but our goal is for you to complete testing within four months.

Part One: Initial Evaluation

Patients begin the pancreas transplant evaluation at the scheduled Multidisciplinary Pancreas Transplant Evaluation Clinic. During the day you will:

  • Attend a pancreas transplant education session
  • Have blood testing done
  • Meet with all the members of the transplant team, including your individual nurse coordinator, surgeon, social worker, dietitian and financial coordinator

Part Two: Specialized Testing

After the initial clinic visit you will return for additional testing and appointments as needed. The pancreas transplant team will assist you in scheduling these tests and appointments, which may include:

  • Cardiac stress testing
  • Chest X-ray and electrocardiogram (EKG) at a Mass General facility
  • Additional blood and urine tests
  • CT scan
  • MRI/MRA
  • Meeting with a pharmacist
  • Meeting with a psychiatrist
  • Meeting with a diabetologist

You will be responsible for scheduling the following tests with your primary care physician and/or providing recent results in order to complete the transplant evaluation:

  • Colonoscopy (age 50+)
  • Dental exam (within the past year)

For women:

  • Pap smear
  • Mammogram (age 40+)

 

Part Three: Review by Committee

Once testing is complete, the entire transplant team will meet to determine your candidacy to be listed for a pancreas transplant. You and your referring physician will be informed of the committee’s decision.

Pancreas transplant candidates are placed on the national United Network for Organ Sharing (UNOS) waiting list, which manages the distribution of organs nationwide.

Learn about the waiting list

Patients with type 1 diabetes can develop renal failure as a consequence of diabetes. Patients can be listed for pancreas transplant alone (with or without previous kidney transplant) or simultaneous kidney and pancreas transplants.

There are many more people waiting for pancreas transplant than there are pancreas donors. If you need a pancreas, you will be placed on a waiting list that is maintained by the United Network for Organ Sharing (UNOS), which allocates organs based upon how long patients have been waiting on the list. If you are also listed for a kidney transplant, you will receive a kidney from the same donor.

As soon as a pancreas is available, you will receive a call from our coordinator or our surgeon asking you to come into the hospital. Since this call can come at any time during the day or night, any day of the week, it is important for the transplant team to be able to reach you. You should provide our center with all of your phone numbers, as well as the phone numbers of a few emergency contacts.

Post-Transplant Care

After transplantation, patients are followed by our team of surgeons, endocrinologists and nurses who manage the post-transplant needs of the patient, including communication with the patient’s primary care physicians and referral to other specialists, as needed.

At the time of your discharge, you will receive extensive instructions for all of your new medications, and for your follow up. It is important to listen to the advice of your transplant team, and to be your own advocate when you have concerns or questions. Following transplantation, you will be taking immunosuppression medications daily to prevent rejection of the organ. These drugs reduce your immune system function, so it is equally important to make sure you do not develop any infections after transplant.

Initially, you will be seen once or twice a week in clinic, and you will have labs drawn twice a week so your doctors can monitor the function of your new organ and make sure the levels of medication in your blood are appropriate.

If for some reason you are unable to take your medications, unable to come to clinic or unable to have your blood drawn, please notify our team immediately so that we may assist you. We have a team on-call 24 hours a day, seven days a week.

Note: In an emergency, please proceed to the nearest emergency room and have the doctor there call us at 617-726-5277.

General Wellness Tips

  • Avoid contact with sick people after surgery
  • Avoid driving until you are off all pain medications and able to move about without any discomfort
  • Avoid heavy lifting for two months following surgery
  • If someone is sick in your household, wear a surgical mask
  • Return to work when you feel comfortable
  • Take walks daily
  • Wash your hands frequently

Possible Symptoms

Please call the Mass General Transplant Center if you have any of the following signs or symptoms:

  • Burning or bleeding with urination
  • Elevated fasting blood glucose levels (above 200 on two or more occasions)
  • Exposure to anyone with mumps, measles, chicken pox or shingles
  • Fever above 100.5
  • Inability to obtain or take your medications
  • More frequent urination
  • Nausea, vomiting or diarrhea
  • New rash
  • Pain, redness or discharge from your incision
  • Productive cough, or a cough that will not go away
  • Shortness of breath