Risks

Apancreas transplant is a major operation. As withall types of surgery, there is a risk of complications.

Some complications can occur soon after the procedure, while others may develop months, or even years, later.

Some of themain risks associated with a pancreastransplant are described below.

Rejection

One of the most common complications of apancreas transplant is rejection of the donor pancreas. This is where the immune system recognises the transplantedpancreas as foreign and attacks it.

Rejection usually occurs in the days, weeks or months after the transplant, although it can sometimes happen years later.

Immunosuppressant medication can reduce the risk of this happening, but can't always prevent it completely.

Symptoms of rejection can include:

• pain and swelling in your tummy
• a hightemperature (fever)
• being sick
• chills and aches
• extreme tiredness (fatigue)
• puffy, swollen ankles
• Shortness of breath

Contact your GP or transplant team as soon as possible if you have these symptoms. Rejection can usually be treated by increasing your dose of immunosuppressant medication.

Immunosuppressant side effects

The immunosuppressant medications you need to take to prevent rejection can have a number of significant side effects.

These can include:

• increased vulnerability to infections
• shaky hands
• difficulty sleeping (insomnia)
• high blood pressure
• hair loss or thinning
• mood swings
• weight gain
• an upset stomach
• a rash
• weakened bones (osteoporosis)
• an increased risk of certain types of cancer , particularly skin cancer

Speak to your transplant team if you experience any troublesome side effects. Don't stop taking your medication without getting medical advice first.

Infections

Immunosuppressant medication will weaken your immune system and make you more vulnerable to infection.

While taking the medication, it's a good idea to:

• report any possible symptoms of an infection to your GP or transplant team immediately things to look out for include a high temperature (fever), aching muscles, diarrhoea or headaches
• ensure your vaccinations are up-to-date speak to your GP or transplant team for advice about any additional vaccines you might need, as some aren't safe if you're taking immunosuppressant medicines
• avoid close contact with anyone who has an infection even if it's an infection to which you were previously immune, such as chickenpox

To help prevent infection, you may be given antibiotics , antifungal medicine or antiviralmedicationto take for the first few weeks or monthsafter your transplant.

Blood clots

Blood clots can sometimes form in the blood vessels that supply the new pancreas, which can stop it working properly.

The risk of this happening is highest in the days after the operation, so you will be closely monitored in hospital to check for any signs of a blood clot.

You'll alsobe given blood-thinning medication to reduce the chances of a clot forming.

If a blood clot does develop in the new pancreas, you'll usually need another operation to remove it.

Blood clots can also form in other blood vessels after surgery, such as those in your legs (deep vein thrombosis) or supplying your lungs (pulmonary embolism) , but taking blood-thinning medication should help prevent this.

Pancreatitis

Pancreatitis is swelling (inflammation) of the pancreas, and is common in the first few days after surgery.

It can occur as a result of storing the donor pancreas on ice in preparation for the transplant.

Symptoms of pancreatitis include:

• a dull pain in your tummy
• feeling sick
• vomiting

Pancreatitis should pass within a few days.However,sometimes tubes may need to be placed in your tummy to drain any excess fluid off the donor pancreas, and in a few cases it may be necessary to remove it.