Memorial to start doing pancreas transplants —could be potential cure for kidney failure
People in South Florida who need a pancreas or pancreas-kidney transplant — a key procedure that could possibly cure both kidney failure and insulin-dependent diabetes — will soon have another option: Memorial Transplant Institute in Hollywood.
The institute, part of Memorial Healthcare System, the public hospital network in southern Broward County, received approval in April to add pancreas transplants to its pediatric and adult kidney and heart transplant programs. The United Network for Organ Sharing, the nonprofit that operates the country’s organ transplant system under contract with the federal government, approved the measure. It’s the first pancreas transplant program in Broward County.
“For an ideal candidate, someone who has diabetes and requires insulin or is on dialysis or is approaching dialysis, putting a kidney and pancreas transplant together is basically a complete cure for kidney failure,” said Dr. Basit Javaid, a transplant nephrologist and chief of Memorial’s Abdominal Transplant Medicine who will run the program with Dr. Seyed Ghasemian, chief of the hospital’s Abdominal Transplant Surgery Program.
The pancreas-kidney transplant also could potentially cure someone who has insulin-dependent diabetes, Memorial said.
The Miami Transplant Institute at Jackson Memorial Hospital in Miami, which is staffed with doctors from the University of Miami medical school, also performs pancreas and pancreas-kidney transplants. Jackson has done 357 pancreas transplants since 1994, and 714 kidney-pancreas transplants since 1990, 18 of which were this year, according to data from the nation’s organ transplant system.
In March, Jackson administrators partially shut down the adult heart transplant program at Miami Transplant institute after complaints arose about patient deaths, infections and other issues. The national organ transplant system signaled to leaders of Jackson Health System, the Miami-Dade public hospital network supported by taxpayers, that it had received complaints warranting an investigation. A Jackson executive last week told the board that oversees Jackson Health a plan was in place to reopen the program, but didn’t elaborate. Jackson’s other transplant programs remain open.
When pancreas transplants begin
Memorial expects to start performing pancreas transplant procedures in June, but patients can begin making appointments or seek consultations now, Javaid said.
In addition to Jackson and Memorial in South Florida, four other centers in Florida offer pancreas transplants: Mayo Clinic Hospital Florida in Jacksonville, AdventHealth Orlando, Tampa General Hospital and UF Health Shands Hospital in Gainesville.
The need is there, Javaid said.
“In this region alone, there are about 10,000 patients with kidney failure and about 2,000 to 2,500 patients are starting dialysis every year,” he said. “Of existing dialysis patients, about 50% have diabetes — an underlying cause of kidney failure.”
Javaid said about 1,500 patients are on a wait list for a kidney transplant in the tri-county area of Miami-Dade, Broward and Palm Beach counties. About 500 of those people could potentially benefit from a simultaneous pancreas and kidney transplant procedure, he noted.
“In general, the individual has to be healthy enough to be able to undergo a surgery without having any major complications. Not everyone is going to qualify, obviously ... [but] there is a dire need for a transplant program in this community and, in my opinion, we probably haven’t even scratched the surface yet,” Javaid said.
Survival rates
According to the National Institutes of Health, the five-year patient survival rate after simultaneous pancreas-kidney transplantation is 87%, while 10-year patient survival is 70%. That’s “significantly better than the survival rates for patients with type 1 diabetes on maintenance dialysis who are on the transplant waiting list,” Javaid said.
“It’s almost a complete cure, both from kidney failure and from the underlying cause of diabetes,” Javaid said.
What does the pancreas do?
The pancreas is a large organ behind the stomach that produces insulin to regulate blood sugar and helps with digestion. When people have type 1 diabetes, which usually affects young people, the pancreas doesn’t produce insulin. People with type 1 diabetes must take insulin injections.
When people have type 2 diabetes — about 90 to 95 percent of the U.S. cases — the pancreas still produces insulin but it doesn’t make enough of it or your body can’t use it efficiently. People with type 2 diabetes don’t always have to take insulin, as it can sometimes be controlled through eating healthy foods and getting exercise to keep your weight down.
When the pancreas fails, the body can’t sustain its blood sugar in a normal range, which can lead to kidney disease, heart attack, stroke and premature death.
Pancreas transplant centers
▪ In addition to the six in Florida, there are more than 100 pancreas transplant centers in the United States.
▪ There have been 510 pancreas transplants in Florida since 1994 and 1,659 kidney-pancreas transplants since 1990, according to the Organ Procurement and Transplantation Network.
▪ There are 836 people waiting for a pancreas transplant in the country and 1,937 waiting for a kidney and pancreas transplant, according to the latest data from the organ network.
▪ In Florida, there are 34 candidates on the wait list for a pancreas and 81 for a kidney-pancreas transplant, according to the organ network.
▪ Jackson has 18 people on the waiting list for a pancreas and 18 people for the kidney-pancreas transplant, according to the organ transplantation network.
“A simultaneous pancreas and kidney transplant will treat a patient’s kidney disease, freeing them from dialysis, as well as the requirement for blood sugar monitoring and insulin – a remarkable improvement in their quality of life,” Javaid said in a statement released by Memorial.
