What to Expect During The Transplant Process
Patients who are referred for a kidney transplant will attend a class taught by a transplant nurse coordinator. The class will outline the entire transplant process, from initial evaluations to surgery and aftercare.
The Initial Evaluation
The evaluation starts with a consultation with the transplant team. This is done to determine if transplantation is the best treatment for you and if you are healthy enough to safely undergo a transplantation procedure. During the initial consultation you will receive a thorough overview of diabetes and kidney disease, organ allocation and transplant outcomes, as well as an overview of GW Hospital’s program and personnel. The transplant coordinator will outline the medical tests and consultations that must be performed as part of the evaluation process.
The next step is for the transplant nephrologist and surgeon to take your complete medical history, conduct a physical exam and review all the outside records, tests and consultations you have previously done. We will order additional imaging, cardiovascular and health maintenance exams if needed based on prior work-up and other health conditions. We may discuss alternative therapies to transplantation and how to best medically manage your diabetes.
Our transplant social worker will then conduct a full evaluation including an assessment of your support system. We will expect you to comply with the Transplant Institute's policies and procedures.
When all the testing and consultations are complete, the multidisciplinary committee will review your case to determine that no other treatment options are available and that you have no contraindications, such as heart disease or vascular disease. You will then be placed on the United Network for Organ Sharing (UNOS) transplant list. If you are not a candidate for pancreas transplant, we may consider you for a kidney transplant.
Waiting for an Organ
Your referring nephrologist, endocrinologist, and primary care physician will continue to manage your healthcare needs while you wait for your transplant. While on the waiting list, you will need to make periodic visits to the GW Transplant Institute so doctors can assess changes in your health status, address concerns and provide support. Visits to the Transplant Institute are not a substitute for routine primary care physician visits.
Patients have an important role to play in the transplantation process. During the wait, it is critically important that you:
- Provide blood samples on a timely basis
- Stay as active and healthy as possible to improve your outcomes after surgery
- Keep all studies up to date, as indicated in the instructions we provide
- Keep us informed of any health changes; these changes (such as recently diagnosed conditions or other surgeries) can affect your ability to receive a transplant
- Ensure we always have the latest insurance information so we can stay on top of any changes in the financial situation
- Contact us with any changes to phone numbers and/or address; just as important, you must leave your phone on around the clock so you can be reached if and when a potential organ becomes available
If we can't reach you, if tests or blood work are not up to date, or if insurance coverage has changed, it could mean the difference between receiving an organ and continuing to wait.
The GW Transplant Institute offers pancreas transplant surgery and a variety of other surgical procedures using advanced technology and equipment, including:
- Simultaneous Kidney Pancreas: A patient receives a pancreas and kidney transplant from a deceased donor.
- Pancreas after Kidney Transplant: A patient receives a pancreas transplant after receiving a kidney transplant (normally from a living donor).
- Pancreas Transplant Alone: In very specific cases where patients that have type 1 diabetes with complications to treatment and no kidney disease, we can transplant a pancreas alone.
In the operation, the pancreas is placed on the right side of your lower abdomen and the kidney is placed on the left side of the lower abdomen, connected to the blood vessels that take blood to your legs. Usually, your own kidneys and pancreas are not removed.
The surgical procedure usually lasts six to nine hours, and your hospital stay is usually two to four weeks. After the surgery, the pancreas begins to make insulin within hours, controlling your blood sugar. From this point on, insulin shots are usually not needed.
After surgery, you will go to the post-anesthesia care unit (PACU) and then to the intensive care unit (ICU) where your glucose levels and urine output will be closely monitored. From there, you will complete your hospital stay in the surgical unit.
Your body will need help adjusting to your new pancreas and kidney. Our transplant team will prescribe medications that will decrease the risk of rejection while closely monitoring your condition and helping you feel comfortable. Working together with your nephrologist and primary care physician, we will arrange effective follow-up checkups and tests.