When receiving a combined kidney and pancreas transplant, both the kidney and pancreas come from the same donor. Both the kidney and pancreas will have been prepared by your doctor before you enter the operating room. This preparation usually takes 2-3 hours.
If the organs are suitable, you will be escorted into the operating suite. The anesthesiologist will greet and evaluate you there. The process of anesthesia and IV line placement can be approximately 1-2 hours depending on your general health condition.
During surgery, a catheter will be placed into your bladder to drain urine. This catheter in generally removed 3 or 4 days after surgery. On rare occasions, depending on your condition, the catheter may be left in place. You will have a voiding trial (test to make sure you can pass urine) later at the clinic before the catheter is taken out.
The surgeon will make an 8-10 inch midline incision from below your chest to right above your pubic bone. In general, the pancreas is placed on the right side of your abdomen and the kidney is placed on the left side of your abdomen. Your own pancreas and kidneys are not removed during this surgery.
Your pancreas has complex connections to your blood vessels and intestines. The pancreas is connected to the blood vessels that lead to your right thigh. The pancreas also has a drainage tube, through which a fair amount of digestive juices are produced. This new pancreas, like your own pancreas, will continue to make digestive juices. The tube draining it will need to be connected to your intestines or less preferably to your urinary bladder for drainage.
The decision as to where your pancreas should drain will depend on your anatomy and the general condition of your intestines. Many times, there is no clear choice until surgery has begun.
The kidney and pancreas transplant surgery will take between 4-6 hours. At the end of surgery, your kidney will have started to function and your pancreas will have started to normalize your blood glucose levels. You will leave the operating room with a tube to drain your stomach inserted through the nose and a catheter in your bladder to drain urine.