If a pancreas transplant is thought to be a suitable option, you will be referred for an assessment.

The aim of the assessment is to determine:

• whether you are healthy enough to have surgery and to tolerate the lifelong post-transplant medication
• whether you are able and willing to take certain medications as directed
• whether you have other health conditions that could prevent the transplant from being successful

During the assessment you will have the opportunity to meet members of the transplant team and ask questions. A transplant co-ordinator will act as your main contact and give you and your family support and advice. They will also explain what happens during the procedure and the risks involved.

In some cases, more investigations may be required before a decision is reached. This may include tests to help rule out coronary heart disease, such as:

• blood tests
• a Doppler scan – a type of ultrasound scan used to test your arteries and veins
• an echocardiogram – where ultrasound waves are used to examine your heart and check how well it is pumping and whether there are valve problems
• coronary angiography – where a special type of dye is injected into a blood vessel so X-rays of the arteries can be taken

The outcome of the assessment may help to determine whether:

• you should join the active waiting list, which means you could be called for a transplant at any time
• you need further treatment before you are fit enough to join the transplant list
• you are unsuitable for having a transplant – if this is the case, the assessment team will explain why and offer you other treatment options, such as medication or an alternative form of surgery
• you need to have a second opinion from a different transplant centre

Waiting for a donor

Once on the active waiting list, staff at the transplant centre will take your details so they can contact you at short notice when a suitable donor organ becomes available.

Finding a suitable pancreas will depend on:

• your blood group
• the availability of a suitable donor organ
• how long you have been waiting compared with others on the waiting list

While you wait for a suitable donor organ to become available, you will be under the care of the doctor who referred you to the transplant centre. They will keep the transplant team informed of any changes to your condition.

Once you are on a waiting list for a transplant it is important to stay healthy. You can do this by:

• taking medication prescribed for you
• keeping all your appointments with your healthcare team
• following recommended exercise and diet advice
• avoiding stress by resting and relaxing as much as possible 
• if you are on dialysis, try to avoid gaining weight in between dialysis sessions – the best way to do this is to eat a healthy diet and take regular exercise

A suitable donor

Staff at the transplant centre will contact you when a suitable donor pancreas is found. If no new medical problems have occurred since your assessment, you will be asked to go to the centre.
 
From this point you should:

• not eat or drink anything unless your blood sugars are very low
• take your medication with you
• pack a bag of clothes and essential items for your hospital stay

You will have a quick reassessment at the transplant centre. As you are being assessed, a second medical team will examine the donor pancreas. The transplant must be carried out as quickly as possible to ensure the greatest chance of it being successful.

As soon as the donor pancreas is confirmed as being in good condition and suitable for use, the transplant procedure can begin.