Rejection and other complications after a pancreas transplant

You can call (352) 265-0254 or (800) 749-7424 ext 5-0254 to make a referral to the pancreas transplant program at the Shands Transplant Center at the University of Florida.

Rejection occurs when your body "sees" that the new pancreas is not like your own body tissues. The body responds by sending special cells to attack the new pancreas. This attack can cause the donated pancreas to fail. Just as the body recognizes a virus as being unfamiliar and develops antibodies or killer cells to get rid of it, the body can form cells to try to get rid of the new pancreas. Rejection is normal. It is the body's way of trying to protect itself.

Keep in mind that you may undergo a rejection without having any symptoms. This is one of the reasons that it is important for you to be followed regularly. Rejection is best treated if found early. It is most important that you keep your Shands Transplant Center appointment as scheduled.

Preventing rejection
Three medications can help the body fight off rejection: CellCept, Prednisone and Prograf. Other anti-rejection drugs such as Cyclosporine and OKT-3 may also be used.

These medications help your body accept the new pancreas. You will have to take these medications for as long as your new pancreas is working. You may experience some of the side effects of the drugs, such as an increase in appetite, weight gain, high blood pressure, and a higher risk of infection. These side effects will decrease as your medication dosages are lowered. If rejection does occur, other transplant medications may be used to stop it.

If you are around anyone who has chicken pox or the measles, contact your doctor immediately. These childhood diseases can cause more severe illness in people taking immunosuppressant medications. Check with your doctor before you agree to any vaccinations. Do not take any other prescribed or over the counter medications without consulting with the transplant team.

Complications after a transplant
Nearly everyone with a pancreas transplant will experience at least one complication along the way. There are many possible complications, but most are minor. You may need to be seen at the Shands Transplant Center more often or be readmitted to the hospital when you have a problem. The medical staff will try to keep you informed of any concerns they might have. Inform the medical staff of any changes regarding your health. Don't forget to ask questions. To be on the safe side, keep your distance from family and friends who are sick.

If you have any of the following, be sure to let your doctor know:

• Temperature 101°F or above
  
• Elevated blood glucose
  
• Nausea/vomiting/diarrhea/ abdominal pains for 24 hours
  
• Decreased urine output
  
• Increasing redness, pain or fluid leaking from your incision
  
• Increasing weakness that does not get better with rest

Do not wait until your next clinic visit or until the weekend is over to report any of these symptoms.

Activities to avoid
There are several activities you should avoid for eight to 12 weeks after a transplant as you recover. Your healing process will be slower due to the effects of Prednisone. Your wound will need more time than normal to completely heal.

Avoid:

• Heavy lifting (more than 10 pounds)
• Activities that will cause a strain in your stomach muscles
• Exercises (sit-ups and straight leg raises)

Statistics
Success rate and various other statistics regarding the Shands Transplant Center at UF are available from the Scientific Registry of Transplant Recipients at ustransplant.org.