Once you have decided to pursue a pancreas or kidney-pancreas transplant at the University Transplant Program, the Rush Pancreas Transplant Care Team will perform a comprehensive pretransplant evaluation.
This evaluation will help to determine your fitness for a transplant, any medical problems which need to be addressed before surgery, and which donor pancreas will be most compatible with you. The evaluation includes the following components:
- Blood typing — Blood is drawn to determine if you are blood type A, B, AB or O. The donor of the organ(s) must have a blood type that is compatible with yours.
- Tissue typing — Blood is drawn to look for specific markers called human leukocyte antigens. These markers are inherited from your parents. In general, the more your markers match with those of the donor, the less likely your body is to reject the transplanted organ(s). It is not necessary to be a match, however. Improvements in medicines have made it possible to successfully do transplants between people who do not share any of these markers.
- Crossmatch — This blood test is like a mini-transplant in a test tube. Some of the donor and recipient’s blood are mixed together and monitored for a reaction that might prevent a successful transplant.
- C-Peptide — This blood test determines whether you have type 1 or type 2 diabetes by measuring how much insulin is produced by your own pancreas.
- Other blood tests — Several tubes of blood will be taken as you start the work-up process. Your blood will be tested for things like: liver function, blood counts, hepatitis, HIV and other viruses that can be reactivated after transplant.
- Diagnostic exams — These exams may include chest X-ray, abdominal ultrasound, electrocardiogram (EKG), and echocardiogram (ECHO). The chest X-ray provides information about your heart and lungs. The abdominal ultrasound shows your internal organs and identifies any abnormalities. The EKG records the activity of your heart to help determine if you have any heart problems and the ECHO uses sound waves to take a picture of your heart to determine how well it is working.
- Endocrinology consultation — A diabetes specialist at Rush who works with transplant patients will meet with you to make sure your diabetes management is optimized and that you would benefit from a pancreas transplant.
- Cardiology consultation — A cardiologist will assess you to rule out any heart problems before surgery. A stress test (which closely monitors your heart rate and rhythm while your heart is being stimulated) is required for all potential transplant patients.
- Social work evaluation — A transplant social worker will meet with you to assess your support system, gaps in insurance coverage, or potential concerns about substance abuse or mental illness.
- Additional tests — A dental exam is necessary to identify possible gum and tooth infection and disease. For women, an annual gynecological exam is required, including a Pap smear. For women who are 40 years or older, a mammogram is also needed. For all candidates who are 50 years or older, a screening colonoscopy is required. Other consultations and tests may be ordered based on your specific medical history.