Pancreas Transplant: What to Expect at Home

Your Recovery

A pancreas transplant is surgery to give you a healthy pancreas. The new organ came from a person (donor) who is deceased. Your surgery may have been combined with a kidney transplant.

Your new pancreas should start working right away. It will make the insulin your body needs. So if you had diabetes before your transplant, you may not have to take insulin to treat your diabetes anymore. Even if you still need to inject insulin, managing your blood sugars may be much easier. Your new pancreas will also make enzymes, or proteins, to help your body digest food.

Your belly will be sore for the first few weeks after surgery. You also may have some numbness around the cut (incision) the doctor made. You may feel tired while you are healing. It may take several months for your energy to return.

After surgery, you may have a tube coming out of your belly near the incision to drain fluid. The tube may be removed in the hospital or after you go home.

After you leave the hospital, you will have regular follow-up appointments for several weeks or months.

After the transplant, you'll have to take medicines every day from now on. The medicines will help keep your body from rejecting the new pancreas. They will also make your immune system weaker. This means you will be more likely to get an infection or become sick. To reduce your risk of infection, wash your hands often. Stay away from crowds of people, and avoid contact with people who have a cold or the flu.

Having an organ transplant can bring up many emotions. Seek out family, friends, and counselors for support. If you think you are depressed, ask your doctor for help. Treatment can help you feel better.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Be active. It can help prevent problems and help you recover. Walking is a good option for many.
• You may take showers. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Avoid exercises that strain your belly muscles and activities that make you work hard, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it's okay.
• Avoid lifting anything that would make you strain until your doctor says it's okay. This may include heavy grocery bags, a heavy briefcase or a backpack, or a child.
• Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
• Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
• Ask your doctor when you can drive again.
• Many people are able to return to work about 1 to 2 months after surgery. It depends on the type of work you do and how you feel.
• Ask your doctor when it is okay for you to have sex.

Diet

• Follow your doctor's instructions about what to eat after your surgery. You may need to follow a special diet for your pancreas or kidney or for other health problems.
• Drink plenty of fluids (unless your doctor tells you not to).
• Check with your doctor before you drink alcohol. Alcohol can cause problems with some of the medicines used to prevent organ rejection.
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take your anti-rejection medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve), or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless your doctor says it is okay.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Don't take any over-the-counter medicines unless your doctor says it's okay.

Incision care

• If you have strips of tape on the cut (incision) the doctor made, leave the tape on until it falls off.
• If the incision is closed with staples, the staples will be removed a few weeks after surgery.
• Gently wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing.
• Change the bandage every day or if it gets wet or dirty.
• Keep the area clean and dry.

Other instructions

• Take steps to avoid infections. If you did not get all the vaccines you need before surgery, be sure to get the ones your doctor recommends in the weeks after surgery.
• Carry a medical alert card with you, and consider wearing a medical alert bracelet. These will tell health care providers you have had a transplant in case you need emergency care.
• Most transplant experts recommend that a person wait for 1 to 2 years after surgery before planning to get pregnant. If you plan to get pregnant, pre-conception counseling is important so you know about the higher risk of problems and need for close monitoring for both you and the baby.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have severe trouble breathing.
• You have sudden chest pain and shortness of breath, or you cough up blood.
• You have severe pain in your belly.

Contact your doctor now or seek immediate medical care if:

• You have pain that does not get better after you take pain medicine.
• You have nausea or vomiting or cannot keep down fluids or your anti-rejection medicines.
• You have loose stitches, or your incision comes open.
• Bright red blood has soaked through the bandage over the incision.
• You have symptoms of a urinary infection (if you also had a kidney transplant). For example:
  • You have blood or pus in your urine.
  • You have pain in your back just below your rib cage. This is called flank pain.
  • You have a fever, chills, or body aches.
  • It hurts to urinate.
  • You have groin or belly pain.
• You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
  • Pain in the calf, back of the knee, thigh, or groin.
  • Swelling in the leg or groin.
  • A color change on the leg or groin. The skin may be reddish or purplish.
• You have trouble passing urine or stool.
• You have pain or swelling in your belly.
• You have a weight gain of more than 2 pounds in 1 day.
• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the incision.
  • Pus draining from the incision.
  • A fever.
• You have any problems with your anti-rejection medicine.
• You have trouble managing your blood sugar.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You do not have a bowel movement after taking a laxative.