Skip to Content

Home | Doctors & Services | Services & Centers | Transplant Services | Kidney and Pancreas Transplant

Kidney and Pancreas Transplant

Patient

Patients with stage 4 or 5, or end-stage renal disease will most often find themselves on dialysis. Patients who qualify may be eligible for a kidney transplant to avoid dialysis and may experience an improved quality of life.

For patients who also have type 1 diabetes, pancreas transplants are a beneficial treatment option. When successful, pancreas transplant recipients no longer require insulin injections because the new pancreas produces insulin. Pancreas transplants are most often performed when a patient has kidney failure and also receives a kidney transplant.

Speak to your dialysis social worker or primary nephrologist to see if you qualify for a referral to Presbyterian Transplant Services.

Referral

Potential transplant candidates can be referred by your primary care physician, a nephrologist, your dialysis unit, or you can refer yourself.

The referral begins with a phone interview with a member of our transplant team and the potential transplant recipient. The transplant team member will have a 20 to 30 minute conversation with you and will go over your demographic information, insurance information, and detailed medical information regarding the cause of your kidney failure and/or diabetes.

At the end of this interview, you will be scheduled for an orientation class, and you will be mailed a packet containing additional information about transplantation. Included in this packet are a background information form and a release of information form. It is important that we receive these completed forms back from you before your orientation. This will help us gather information we need from your doctors and speed up the process.

To help make the process easier and quicker, these forms are provided here for you to print, fill out and mail back to us.

Orientation

The transplant orientation class will give recipients, families, and potential donors a general overview of the kidney/pancreas transplant process and provide a chance for them to give informed consent. Attendance at this meeting is required before potential transplant patients are scheduled for an initial evaluation. The class will last about 2.5 hours.

Initial Evaluation

You will meet with your transplant coordinator, social worker, and a nephrologist. You will also be asked to have lab work and a chest x-ray done. This is a 4-hour appointment. At this time, the nephrologist and coordinator will assess your medical history to determine what type of medical tests you should have in order to be considered a candidate for transplant. Please be sure to let your coordinator know if you have any possible living donors.

Learn more about living donation

Medical Tests

Your medical tests will help the team determine if you are healthy enough to undergo a kidney or pancreas transplant. Refer to the list below of tests that may be included.

Surgical Evaluation

You will meet with the transplant surgeon who will assess your ability to undergo the transplant surgery, as well as discuss the risks and benefits specific to your case. This meeting will take about 30 minutes.

Listing

Transplant Selection Committee

The transplant selection committee is made of up transplant nephrologists, transplant surgeons, transplant coordinators, social workers, pharmacists, and a financial coordinator. The entire team will discuss your case and decide if a transplant is a safe treatment option for you and if you should be placed on the deceased donor list. Your coordinator will call and let you know the decision and send you an official letter of the committee’s decision.

While You Are Listed

It may take several years before you are called in for your kidney or pancreas transplant. While you are waiting, we want to make sure that you stay healthy and keep up-to-date on any required medical testing. Here’s a list of items to help you be ready for your transplant:

Compliance
Make sure you are compliant with dialysis, diet, medications, and testing while you are listed. We want to make sure you are in satisfactory condition when you are called in with an organ offer.

Keep In Touch
Please let your transplant coordinator know if your health changes in any way. Also, let us know right away if your phone number or address changes. In addition, let us know if you are traveling out of state.

Functional Status
Keep moving! Please keep doing the best you can to maintain your physical fitness prior to transplant. It will be important to be in good shape going into transplant, so that you will recover well after transplant.

Sunscreen
Please start wearing sunscreen each day, even in the wintertime. New Mexico is bright and sunny year round and this may cause skin cancer. When patients are on special medication after transplant, they can be more prone to developing skin cancer, so start now by protecting yourself from the sun.

Additional Testing and Appointments

Each year, you may be required to have the following tests and/or appointments:

Nephrology
You will need to come in to the clinic to see the Transplant Team periodically. The frequency will be determined by the Transplant selection committee. It may be every 6 months to every 2 years. These appointments will be scheduled by your transplant coordinator. It is also important to keep your transplant coordinator updated on any new medical issues that arise while you are on the transplant list.

Surgical Visits
You may need to see the Transplant surgeon periodically. This will be determined by the transplant selection committee on an individual basis. Your transplant coordinator will arrange the scheduling of this appointment as needed. It is also important to notify your transplant coordinator if you have any other surgeries while you are on the transplant list.

Cardiology Visits
While you are listed, your transplant coordinator will help schedule a visit to the cardiologist for an updated assessment every 6 months to 2 years, as determined by your heart doctor or the transplant selection committee.

Chest X-Ray
Your transplant coordinator will help you plan and schedule this yearly.

Lab Work
The transplant team will help you determine what lab work is appropriate for you to have each year.

Mammogram
All women over the age of 40 will be required to have a yearly mammogram.

Colonoscopy
All patients over the age of 50 will be required to follow the recommendations of colonoscopy frequency. A repeat colonoscopy is based on the gastroenterologist’s recommendations after your first colonoscopy.

Surgery

Kidney Transplant Surgery

During surgery, the kidney transplant patient is given general anesthesia and placed on a ventilator to help control your breathing. A long incision is made in the lower abdomen on one side. The donor kidney is placed in the lower abdomen, either on the left or right side. The renal artery and vein are attached to the recipient’s iliac vessels to provide blood flow to the kidney. The donor ureter (the tube that drains urine from the kidney) is then connected to the bladder. The incision is closed with stitches or surgical staples. A drain is placed in the incision site to reduce swelling and a Foley catheter is placed to drain the urine in the bladder. The kidney transplant surgical procedure takes approximately three to four hours, but may be different for every patient.

Pancreas Transplant Surgery

Simultaneous Pancreas and Kidney Transplant (SPK)

The transplant recipient is given general anesthesia, is placed on a ventilator, and an incision is made in the middle and lower abdomen. It is usual for both kidney and pancreas to be transplanted together from the same donor. The donor kidney is placed on the lower side of the recipient's abdomen, where it is surgically connected to blood vessels and the bladder. The new pancreas is then placed on the lower side of the recipient's abdomen, where it is also surgically connected to nearby blood vessels. Once all connections have been made, the incision is closed. The kidney/pancreas transplant surgical procedure takes approximately five to seven hours to complete, but this timeline may be different for every patient.

Pancreas After Kidney Transplant or Pancreas Alone (PAK or PA)

The pancreas transplant recipient is given general anesthesia, is placed on a ventilator, and an incision is made in the lower abdomen. The patient’s diseased pancreas is not removed during the operation. The donor pancreas is placed in the lower portion of the patient's abdomen and attached to their blood vessels, and intestine or bladder. The pancreas surgical procedure takes approximately four to five hours to complete, but this timeline may be different for every patient.

Post-Transplant Care

Right before surgery and during the stay in the hospital, the Transplant Team will meet daily with the transplant recipient and their caregiver to provide education on post transplant care. Information about all the medications will be provided to you. Information on transplant medications, side effects and how to take the medications will be provided. Instructions on how to monitor your blood pressure, heart rate, weight and temperature. To ensure that the transplanted organ is functioning well, it is also important to measure and record fluid intake as well as urine output for at least six weeks after the transplant surgery. All transplant recipients are provided with their transplant medications, and a discharge binder that will include all appointment schedules, lab schedule, medication list and a health record to keep track of all necessary information. Our goal is to help all the transplant recipients feel comfortable and confident about taking care of themselves before you go home.

After being discharged from the hospital you will have frequent lab draws and appointments with the Transplant doctors and the Transplant Team. We will be monitoring your health closely after the transplant and during your follow up appointments. Therefore, it is very important to keep your scheduled lab and follow-up appointments. It is important to bring your post-transplant notebook and medicines to each Transplant Clinic visit.

Most transplant recipients recover fully, return to work, and resume a normal, active life within one to two months after receiving their transplant. To decrease the chance of infection, you must avoid people with colds or flu for at least three months. By avoiding illness now, you will be able to return to an active life within a few months.

While we encourage your primary physician to participate in your care and to continue to monitor your health after your transplant, we recommend that, for the first 12 months after your transplant, you receive the majority of your healthcare at our center. The transplant program must be notified of any change in your lab results or any medication changes. You should also continue to see any specialists who have been involved in your healthcare, such as your cardiologist, gynecologist, or, in case of younger patients, pediatrician. If you are seen by other providers, the transplant program must be notified of these providers.

Tips for a Healthy Transplant Recovery

  • Take all your medicines exactly as prescribed
  • Keep all of your scheduled appointments with the Transplant Team
  • Call the Transplant Team if you have any questions or concerns
  • Have your blood drawn as instructed by the Transplant team
  • Follow your recommended dietary plan
  • Follow your recommended fluid intake
  • Follow your recommended exercise plan
  • Avoid being around anyone who has an infection

Call the Transplant Team

If you experience any of the following, call (505) 841-1434 during normal business hours. After hours, call (505) 841-1234 and ask for the transplant coordinator on call.

  • A fever higher than 100°F (38°C)
  • Flu-like symptoms such as chills, aches, headaches, dizziness, nausea or vomiting
  • New pain or tenderness around the transplant
  • Fluid retention (swelling)
  • Sudden weight gain greater than 4 pounds within a 24-hour period
  • Significant decrease in urine output

Education and Links of Interest