Pancreas Transplants Can Help Diabetics

Surgeons at The University of Texas-Houston Medical School are hoping that a new Medicare policy to pay for pancreas transplants will bring more awareness to a procedure that is changing the lives of many insulin-dependent diabetics.

Starting July 1, Medicare will cover two types of transplant procedures: Simultaneous Pancreas/Kidney (SPK), and Pancreas After Kidney (PAK). "It's a major breakthrough," says Dr. Scott Gruber, associate professor of immunology and organ transplantation at the Medical School. The third procedure, Pancreas Transplant Alone (PTA), will not be covered.

The vast majority of pancreas transplants are performed on diabetics. Clusters of cells in the pancreas called islet cells produce insulin. However, in people with Type 1 diabetes, also known as insulin-dependent diabetes mellitus (IDDM), these cells are destroyed and don't produce enough insulin to regulate blood sugar levels.

Pancreas transplants are generally done on diabetics under the age of 60 with imminent kidney failure or who no longer respond to insulin therapy. "Patients have to be on insulin usually for at least 10 years before I would consider them for a pancreas transplant," says Dr. Gruber, "but that is becoming a gray area." Transplant recipients no longer need daily insulin shots, and diabetes-related diseases like eye and nerve degeneration can either stabilize or improve.

Since the first operation in 1966, more than 10,000 transplants have been performed around the world. UT-Houston's pancreas transplant program, begun in December 1996, ranks among the top 10 in the U.S. in terms of numbers of solitary transplants (PAK and PTA) performed.

Despite the health benefits and improved success rate of pancreas transplants, many in the medical community are still unaware of the procedure. "You'd be surprised how many physicians have never heard of or know nothing about pancreas transplantations," says Dr. Gruber. "That's why we have to continue to educate physicians and insurance companies about it."

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©2006 Texas Medical Center

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