Your donor organ(s) may become available at any time, day or night. When the time comes, a transplant nurse coordinator will call to tell you that a transplant is available. It is vitally important that you let us know then of any recent illness, infection or fever, or if you have had a recent blood transfusion. Although tests to determine the compatibility of the transplant will have been performed before you are called, you may be asked to come to Rush for an additional blood sample.
When you are notified to come to Rush for your transplant, you will be instructed to come to the hospital admitting area (fourth floor of the Atrium Building, 1650 W. Harrison St.) or the emergency room (500 S. Wood St.), depending on the time of day. Depending on the circumstances, you may go to the transplant floor of the hospital for final preparation for surgery, or you may go directly to surgery.
The final preparation for transplant will include blood and urine samples, a chest X-ray and an electrocardiogram. If you are on dialysis, you may need a dialysis treatment before transplant surgery depending on when you were last dialyzed and the results of your blood tests.
Depending on your specific needs, you either will be receiving a pancreas or a pancreas and a kidney. The pancreas produces insulin, a hormone that regulates blood sugar levels, and the kidneys cleanse the blood of impurities, which are discharged from the body in urine. A pancreas transplant is performed to treat a patient with diabetes whose pancreas no longer produces enough insulin. A kidney-pancreas transplant is performed to treat a patient whose diabetes has caused kidney failure.
A pancreas transplant is a procedure during which a pancreas from another person is placed inside and connected to your body. The operation involves connecting the artery and vein from the donor pancreas to your own blood vessels. This provides blood supply to the new pancreas and allows insulin to be released into your blood stream. A short length of the organ donor’s small intestine comes attached to the transplanted pancreas and is connected to the recipient’s small intestine during the transplant. This allows for drainage of the digestive enzymes that your new pancreas produces as part of its normal function. By itself, a pancreas transplant usually takes about four to six hours.
A kidney-pancreas transplant is similar to a pancreas transplant, but also involves placing a kidney (from the same donor as the pancreas) into the recipient thru the same incision. Just like the pancreas transplant, the artery and vein of the donor kidney is attached to the recipient’s blood vessels. Then the donor kidney’s ureter (which brings urine from the kidneys to the bladder) is connected to your bladder, so that urine is removed in the normal way. A combined kidney-pancreas transplant usually takes six to eight hours.
For either kind of transplant, you will be under anesthesia throughout the procedure. Both surgeries require an incision in your abdominal area beginning above the belly button and going down toward the groin. Your own kidneys and pancreas will not be removed during the surgery.
Both operations include the temporary insertion of a bladder catheter to measure urine output and a central venous catheter (placed in the neck) for blood draws and intravenous medications.
As with any surgery, bleeding can occur, and you may need a blood transfusion. If you do not wish to receive blood, surgeons at Rush sometimes can perform transplants without blood transfusions, as some religions require.
After your transplant surgery, you will spend time in the surgical intensive care unit (SICU) for close monitoring. Most people are transferred from the SICU to the transplant unit the day after surgery.
While you are in surgery, your family may wait in the Smith Lounge, the surgical waiting room on the fourth floor of the Atrium Building. Once you are moved into the SICU, your family will be able to visit you. Your family must observe the visiting hours and rules appropriate to each unit. Overnight guests are not allowed in patient rooms. The Hospital Guest Relations Department can provide a list of accommodations in the area. Just call (312) 942-5574 and someone will help you.
Potential Complications for Transplant Surgery
As with any surgery, transplant has certain risks. These risks include the following potential complications:
- An allergic reaction to general anesthesia
- An adverse reaction to antirejection medications
- Infections in the incision, urinary tract or lungs (pneumonia)
- Blood loss significant enough to require blood transfusion
- Blood clots in the legs
- Gastrointestinal problems such as a blockage of the intestines, constipation or bloating
- Incisional pain and development of scar tissue
- Rejection of the new organ(s)
- Clotting of a blood vessel in the new organ(s)
- Delay in the function of the new organ(s)
- Failure of the new organs to work well enough to avoid insulin or dialysis
- Other unforeseen complications
- Potential risk for contracting infectious diseases if the disease cannot be detected in the infected donor at the time of organ recovery
Although very rare, some transplant recipients die due to complications from transplant surgery.