Driving License...donate Pancreas?

[LindaH]

Sorry, I'm not too sure if I'm in the right area to discuss this, but I was just so surprised when I needed to recently update my driving license due to newly aquired Diabetes, they were asking people to donate various organs should you die in a car accident and I noticed the Pancreas was one organ they ask you to donate.....why?

Does this mean people can go on a waiting list to have a new Pancreas? If so, how come we are not offered this when we are seen by consultants and especially where you have an inoperable tumour?

Linda

[DRAD3]

Good question Linda!!

Have just googled and found the following:-

Wikipaedia quotes "Patients with pancreatic cancer are not eligible for valuable pancreatic transplantations, since the condition has a very high mortality rate and the disease, being highly malignant, could and probably would soon return."

On the organ donation website, one of the reasons given for not offering pancreas transplant "non-curable malignancy".

NHS site quotes reason "you have a recent history of cancer, because there is a greater chance that the cancer could spread once you are on immunosuppression for the transplant".

Seems that this type of procedure is only offered to patients with Type I Diabetes.

Disappointing, I know. We must keep questioning and looking for answers though. The more we understand, the more our chances of coming up with an answer that will start saving lives.

Deb

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[PCUK Nurse Dianne]

Hi Linda,

Thanks for raising the question about 'pancreas donation' and also thank you to Deb for your very succint reply. Deb is absolutely correct. Pancreas transplants are quite difficult operations with mixed outcomes, including lengthy recoveries, and high morbidity in some patients. Again, Deb has mentioned that those patients with a malignancy are unfortunately not suitable candidates for organ transplants. This is for 2 reasons. The first being that the malignancy may not be contained with in the suspected organ (ie pancreas in this instance) and although there may not be evidence of spread it may become apparent at the time of or post transplantation. Due to organ shortages worldwide at present this is not considered to be the most efficient use of organs. In most organ transplant situations the expected outcome is > 5 year survival post transplant and although this may not always be achieved, this is the aim.

Deb also mentioned the use of immunosuppression mediction affecting the chance of the cancer spreading/recurring. Again this is correct. Once a patient has an organ transplant they will be required to take immunosuppression for the remainder of their life, this is to prevent their immune system attacking the new organ as it sees it as 'non-self' when compared with the remainder of the body. The immunosuppresion medication lowers the patient's immune system and this may then allow cancer cells to replicate. Unfortunately there is a form of 'post transplant' cancer called PTLD (post transplant lymphoproliferative disorder) that patients who have had a transplant are at risk of developing due to their immunosuppression regime and effect on the body.

Also for those patients with Pancreatic cancer who may have had treatment, ie chemotherapy or radiotherapy even, this can make any surgery in this area more difficult due to the effect of these treatments on the surrounding tissues, also increasing surgical risk.

Having said this, there are some exceptions where transplant will take place if the patient has a malignancy, ie liver transplants. There are very strict criteria for this, the patient requires a period of surveillance and appropriate treatment before hand and this is a very different form of cancer than that associated with pancreatic cancer.

I hope this helps and is not confusing to those reading this.

Best wishes,

Dianne

Support Team

Dianne

[LindaH]

Thank you Deb and Dianne. Fascinating information.

Linda x

[Slewis7313]

I had also wondered about (the apparent lack of) this option for PC sufferers. It again seems to reinforce what a complex and difficult Illness this is!

And to think, 3 months ago I had no idea what the pancreas was / did!

[DRAD3]

Absolutely! It is very complex and every sufferer has their own unique presentation of it. I guess organ transplants will always be out of the question in cancers that are difficult to diagnose early. I, like you, was completely ignorant about the pancreas (am still no expert) but hope PCUK make some headway in their goal to raise awareness. Here's hoping that one day soon, things will be better.

Deb

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