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Note: All links within content go to MayoClinic.com

Your pancreas is a narrow organ about the length of your hand that lies behind your stomach. It releases enzymes into your small intestine to break down nutrients. It also releases hormones into your bloodstream to help your body use sugar (glucose). One of these hormones, insulin, acts as a gatekeeper, letting glucose into your cells. The cells use the glucose as fuel for energy production.

When your body is unable to regulate the amount of glucose in your blood, you may have diabetes. Type 1 diabetes occurs because your pancreas produces little or no insulin. In type 2 diabetes, your pancreas produces insulin, but your body doesn't use that insulin efficiently.

A pancreas transplant is a successful treatment option for people who have advanced type 1 diabetes or who don't respond well to standard insulin treatments.

Many people with type 1 diabetes can manage their disease by following a diet and exercise plan, monitoring their blood glucose, and receiving insulin injections. But for some people this is a difficult task, resulting in a number of serious short- and long-term complications.

A pancreas transplant is the closest thing to restoring normal pancreas function. A pancreas transplant isn't the best option for all people with type 1 diabetes, however, and is primarily recommended for people with kidney failure.

If your doctor recommends a pancreas transplant, he or she will likely refer you to a pancreas transplant center for an evaluation. You're also free to select a transplant center on your own. Discuss with your health insurance provider which pancreas transplant centers are covered under your insurance plan.

When considering a transplant center, take into account the number of pancreas transplants the center performs each year and its organ and patient survival rates. You can compare transplant center statistics through a database maintained by the Scientific Registry of Transplant Recipients.

Also consider additional services provided by the transplant center. Many centers coordinate support groups, assist you with travel arrangements, help you find local housing for your recovery period or direct you to organizations that can help with these concerns.

Once you decide where you would like to have your pancreas transplant, you'll undergo an evaluation to determine whether you meet the transplant center's eligibility requirements. These requirements include medical and emotional components as well as a determination that you can abide by the strict drug regimen that follows the transplant.

Simultaneous kidney-pancreas transplants
More than half of all pancreas transplants are performed along with a kidney transplant. The strategy is to give you a healthy kidney and a pancreas that is unlikely to contribute to diabetes-related kidney damage in the future. In most cases, the organs come from the same deceased donor.

This dual transplant appears to contribute to better survival rates for both organs. After five years, the survival rate for the pancreas in a simultaneous transplant is 70 percent, while the organ survival rate for other pancreas transplants is 52 percent.

Pancreas-after-kidney transplants
You may also receive a pancreas transplant after a successful kidney transplant. The treatment goal is similar to a simultaneous transplant. The normal insulin function of your new pancreas should decrease the potential for diabetes-related kidney damage.

Pancreas-alone transplants
Pancreas-alone transplants are performed when there is normal or near-normal kidney function. Your doctor may recommend this option if you have frequent insulin reactions or poor blood glucose control despite the best efforts to manage the disease.

If your insulin treatment and other disease-managing strategies are working, a pancreas transplant is most likely not a better option. According to a study published in JAMA, the Journal of the American Medical Association, in 2003, people with working kidneys who received a pancreas-alone transplant had a lower survival rate than that of people with comparable diabetes severity who followed their regular insulin and disease management treatments.

Pancreas islet cell transplants
An experimental procedure called a pancreas islet cell transplant provides you with new insulin-producing cells from a donor pancreas rather than a whole organ. As this minimally invasive procedure is improved, it may prove to be another viable option for people with type 1 diabetes.

If the transplant center medical team determines that you're a good candidate for a pancreas transplant, the transplant center will register you on a nationwide waiting list. On any given day, approximately 2,500 people are waiting for a kidney-pancreas transplant, and 1,700 for a pancreas-alone. Yet in any given year, there are only enough donors for about 900 kidney-pancreas transplants and about 500 to 600 pancreas-alone transplants.

When a donor pancreas or kidney-pancreas becomes available, the donor-recipient matching system considers three biological criteria:

• Blood type (A, B, AB or O).
• Tissue type — genetic profiles that indicate how compatible your tissue will be with that of the donor.
• A crossmatch, or antibody test, which determines whether you have specific antibodies to the possible donor. An antibody is an immune-system protein that is "tailor-made" to attack a particular foreign substance.

The United Network for Organ Sharing (UNOS), the nation's organ procurement and allocation network, will consider the biological matching criteria, time spent on the waiting list, and distance between donor and recipient when looking for an appropriate match for a donor organ. Some preference in organ allocation is given to children. When a pancreas becomes available, the transplant should occur within 12 to 18 hours.

The need for a new pancreas far outpaces the number of donations. A transplant from a living donor is one strategy to alleviate the pancreas shortage, but this procedure is still evolving. To date, only about 50 living-donor pancreas transplants have been performed. Most of these pancreases were used in simultaneous kidney-pancreas transplants. The recipient received a kidney and a portion of the pancreas from the living donor.

Simultaneous kidney-pancreas transplant surgery will last about five to seven hours. Pancreas-after-kidney and pancreas-alone transplant surgery usually lasts two to four hours.

Your own pancreas will most likely not be removed. The surgeon will transplant the new pancreas with a small portion of the donor's small intestine still attached into your lower abdominal cavity. Your new pancreas should start working immediately, and your old pancreas will continue to perform its other functions.

You will experience some soreness or pain around the incision site. The recovery time in the hospital, usually at least seven days, will depend on how well you and the new pancreas are doing.

After you leave the hospital, the medical team will monitor you closely for an additional four to six weeks. You will be expected to have accommodations within a relatively short commute of the transplant center during this time.

Even with the best possible match between you and the donor, your immune system will try to reject the new pancreas. Your drug regimen will include immunosuppressants — drugs that suppress the activity of your immune system. You will almost certainly take some of these drugs for the rest of your life.

Some of your medications may cause noticeable side effects. Your face may become round and full, and you may gain weight, develop acne or facial hair, or experience stomach problems. Some of the effects are more pronounced when you first start the drug regimen, but their intensity may decline later on.

Your post-transplant treatment, therefore, will be a delicate balancing act between preventing rejection and managing unwanted side effects. Your doctor will monitor your treatment closely and adjust it as necessary. You will also be expected to follow a diet designed to keep your new pancreas healthy.

Most people who receive a pancreas transplant enjoy a high quality of life. The patient survival rate of a pancreas with a simultaneous kidney transplant is 86 percent within the first year, 77 percent at three years and 70 percent at five years.

The survival rate for the pancreas in a pancreas-after-kidney or pancreas-alone transplant is 81 percent at one year, approximately 65 percent at three years and 52 percent at five years.

Your new pancreas may fail because of organ rejection or other factors that could not be controlled. If this happens, you can resume insulin treatments and consider a second transplant. These decisions will depend on your health at that time, your ability to undergo surgery and your expectations for maintaining a certain quality of life. Discuss these choices with your doctor, transplant team and family to determine what's best for you.