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Recovery and Next Steps
Recovery After Pancreas Transplant Surgery
After pancreas transplant surgery, patients begin their recovery in an intensive care setting. There they are closely monitored for approximately two days (or as long as needed), after which they are transferred to the Transplant Unit for the remainder of their hospitalization.
Immediately following the surgery, patients may have pain. This will be carefully monitored and controlled by the transplant care providers. Most transplant recipients have a significant reduction in pain two to three days after surgery. Intermittent pressure boots or sleeves around the legs are used to prevent blood clots.
On average, patients leave the hospital about seven to ten days after surgery. Length of stay in the hospital can vary depending on the severity of illness prior to transplant or complications after surgery. Patients will continue their recovery after leaving the hospital. For the first four to six weeks, patients will have some restrictions on daily activities.
During the recovery period, the transplant team closely follows each patient's progress. Transplant recipients will need to be monitored on a long-term basis, and must return to the hospital regularly for examinations, laboratory tests, and abdominal scans: the usual schedule calls for follow-up visits twice a week for the first month, once a week by month two, and every other week by month three.
Every effort is made to transition patients' routine medical care to their primary nephrologist/endocrinologist. Although the intervals between follow-up visits will become longer, patients will continue to be followed in the transplant clinic for life. For most patients, this involves frequent lab work and a yearly clinic visit. Patients who develop complications may need to be seen more often by the transplant team.
Life After a Pancreas Transplant
The decision to undergo organ transplantation carries with it the responsibility to care for and maintain one's new pancreas and overall health for the rest of one's life. Patients must conscientiously adhere to their medication regimen and their team's recommendations regarding diet, exercise, and lifestyle.
Once at home, patients will need to monitor their vital signs, blood sugars, and continue to take their medications as directed in order to prevent rejection of their new organs. Because of the increased risk of infection caused by taking immunosuppressant medications, patients will need to:
- practice excellent hygiene,
- maintain good dental care,
- and be vigilant about exposure to infectious.
The transplant team provides thorough instructions about all of these issues and is available at all times to answer questions.
Organ Rejection After Pancreas Transplantation
The pancreas is more immunologically active and a transplanted pancreas is more likely be rejected than a kidney. Pancreatic rejection is also more difficult to detect than kidney rejection.
Immunosuppresant medication regimens, which usually include several drugs combined to prevent rejection, are tailored to each patient and are important to the long-term success of the transplant operation. These drugs make patients more susceptible to infection, particularly in the first few months when higher doses are needed.
If doctors suspect that organ rejection is occurring, they will:
- monitor blood work such as pancreatic enzymes,
- monitor blood sugars,
- and biopsy pancreatic tissue.
If these tests indicate signs of rejection, patients should be reassured that many people experience episodes of rejection, and such episodes do not indicate that they will lose their new pancreas. Very often, no symptoms are present, and adjusting the immunosuppressant medications resolves the problem.