I have a new pancreas. What now?

The first 90 days following transplantation are often the most difficult in terms of complications. Therefore, we will work closely with you to prevent, detect and manage these and any other problems.

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Before you leave the hospital, you will be given handouts that cover general information regarding care following pancreas and pancreas-kidney transplantation. We strongly encourage you to contact our office if you have any questions or concerns, or if you think you may be developing a problem. We rely on you to provide us with information that will help us monitor your recovery.

When you return home from the hospital, we will ask you to monitor your own temperature, blood pressure, urine intake and output, urine pH levels and blood glucose, and to keep track of the immunosuppressive medications you take each day. You will record this information several times daily on a flow sheet provided by our staff. It is vital that you carefully and accurately record this information, for it will help us make important decisions about your immunosuppressive treatment and other aspects of your post-transplant care. The flow sheets offer additional space for you to record comments or concerns. There is also a page where you can list questions to be discussed at your next clinic visit.

Sandra Retzke with her first pizza since developing diabetes at age 8.

Clinic visits are scheduled on Mondays and Thursdays at the University Transplant Program office, Suite 161, Professional Building III, 1725 West Harrison, on Rush's main campus in Chicago. At these visits, we will examine you, check your blood pressure and pulse rate, and evaluate your urine and blood samples. To improve the accuracy of our blood tests, please do not take your Cyclosporine or Prograf on the morning of your clinic visit. You may take your medication at the clinic, after your blood has been drawn.

Detecting pancreas transplant rejection is a complex task. We will monitor you for signs of rejection through frequent blood and urine tests, conducted to measure your serum amylase, urine amylase and urine pH. We may also biopsy your transplanted kidney or the new pancreas-a procedure that involves removing a tiny slice of tissue from the organ for further testing.

Hematuria (or blood in the urine): It is common for patients to see some blood in their urine immediately following a transplant. However, the presence of blood in your urine once you have returned home from the hospital could indicate a problem. If you have blood in your urine for two days in a row, contact our office. This may be a sign that you have an infection. Early detection and attention will simplify the treatment of either problem. Anastomotic leak: If you develop severe and persistent pain in the lower part of your abdomen, contact the transplant office. This could indicate that pancreatic fluids or urine are leaking into your peritoneal cavity. Again, early detection and management will simplify the treatment of this complication.

Jose Gomez and his mother enjoy outdoor activities since his transplant.

Infections: Fever, chills and an overall feeling of sickness, along with pain along the side of your pancreas, may be signs of pancreatitis. If these symptoms occur, contact our office.

To ensure the long-term success of your pancreas transplant, you must be dedicated to controlling your immunosuppression and maintaining a healthy lifestyle. You must also carefully manage and treat the secondary complications of your diabetes. To do this, you should see an ophthalmologist at least once a year for the detection and treatment of diabetes-related eye disease. You should also see your family physician at least once a year for a routine physical examination, including an electrocardiogram, and an examination for heart or artery disease.

Female patients age 50 and older should have an annual mammogram and breast examination. Additionally, all female patients should have an annual gynecological examination and PAP smear. Male patients should have an annual prostate exam, along with the prostate specific antigen (PSA) test, a simple blood test that may detect early signs of prostate cancer. Transplant patients should undergo routine cancer screenings, following the same guidelines that apply to everyone in the general population.

Mark Thompson enjoys a sweet treat after 18 years without desserts.

As your condition improves, fewer clinic visits will be required. About six months after your transplant, you will return to your family physician for your regular care, but we will continue to see you once every month or two to monitor your recovery. Your visits to the Rush transplant office will gradually become less frequent, but be assured that we will always be there to help if you have problems or concerns.

It is helpful for us to learn how you are doing in the months and years following your transplant. Has your sight changed? Has there been a return of feeling in your feet? How do you feel overall? This is vital information for us and for other patients. In a sense, you are helping determine the course of medical science and therapy. Your contribution is very important.