During the evaluation, you will undergo a number of medical tests such as:
- Blood tests to determine your blood type; liver and kidney function; viruses to which you may have been exposed such as hepatitis A, B, and C, and the AIDS virus; and tissue typing
- Chest x-ray to see if your lungs are healthy
- Electrocardiogram (EKG or ECG) to look for heart abnormalities or evidence of past damage
- Echocardiogram that allows the doctors to look at the function of your heart
- Stress test, which uses exercise or medications to stress your heart so physicians can check for evidence of coronary artery disease
- Cardiac catheterization if coronary artery disease is present
- Vascular studies such as an ultrasound or angiogram to assess blood flow to the legs if necessary
People who are over age 50 will need to have a colonoscopy, a study to check for colon cancer. Men over 50 will need a prostate-specific antigen (PSA) test to screen for prostate cancer. Women will need a mammogram and Pap smear.
Blood and Tissue Typing
Your ABO type will be determined (A, B, O or AB). In addition, we will test your HLA (Human Leukocyte Antigens) type, which is a test of certain proteins in your blood that are important for transplant matching. Although the HLA typing was very important in the past, with modern transplant medications, the effect of matching on the success of the pancreas transplant is not as important today. You will also have your blood checked for antibodies against human leukocyte antigens that may be on potential donors. This will help your doctors determine how hard it will be to find a suitable donor.
If a potential organ donor is identified for you, a test will be performed called the "crossmatch." In this test, a special laboratory mixes the serum (liquid portion) from your blood with white blood cells of your potential donor. The test will be positive if you have fighting units in your blood, called antibodies, that specifically attack the potential donor's cells. A positive crossmatch means that you cannot receive an organ from that particular donor, without a number of special procedures and medications (called "desensitization"). The test will be negative if you do not have any detectable antibodies against the donor's cells. This test will be important in determining your body's ability to accept a pancreas from a particular donor.
Once you are on the pancreas transplant list, you are required to submit monthly blood samples so that recent samples are always available for crossmatching, should a donor become available.
Simultaneous Pancreas and Kidney Transplant
There will be some extra steps and tests for the medical evaluation if the transplant team recommends that you consider a simultaneous pancreas and kidney transplant. Our team will also discuss with you the benefits living donor kidney transplantation, and
preemptive kidney transplant (before dialysis), which can improve outcome for patients with type 1 diabetes in particular.