Addenbrooke s on top for life-changing pancreas 21 February 2014 Patients at Cambridge University Hospitals have the best outcomes in the UK for a rare kind of operation, which sees the kidneys and pancreas replaced simultaneously, in order to treat chronic Type 1 diabetes. Placing well above the national average for kidney and pancreas, 87% of patients who have undergone the have a working pancreas and kidney after five years. Specialist nurses Stephanie Smith and Gail Defries, along with consultant Professor Christopher Watson are delighted with the transformation offered by the surgery. Professor Watson said, The gives patients freedom from dialysis and a quality of life which before their surgery was impossible. Combined kidney and pancreas is offered to some patients with Type 1 diabetes, who are undergoing dialysis due to complete kidney failure. There are two types of diabetes, with Type 1 accounting for around 10 per cent of the estimated 2.9 million total cases in the UK (Diabetes UK). Type 1 diabetes is an often inherited autoimmune disease, which sees the body s immune system destroy its own insulin-producing cells. Insulin is produced in the pancreas and is essential for the conversion of carbohydrates into energy. Patients with Type 1 diabetes can experience dangerously high blood sugar levels, risking nerve damage, blindness, organ failure, heart disease and stroke. The complications of Type 1 diabetes during pregnancy can lead to miscarriage and severe birth defects. In Type 2 diabetes, insulin is produced, but not fully utilised. In the middle of the night Debbie Voda had a combined kidney and pancreas at Addenbrooke's in 2003 after experiencing complete renal failure due to lifelong diabetes. Now a qualified nurse, Debbie, 40 from St. Neots, is celebrating the first birthday of her son Daniel. Addenbrooke s on top for life-changing pancreas Page 1
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They called me in the middle of the night to tell me that kidneys and a pancreas had become available. This was the third time I d had the call the first two were postponed because of an infection and unsuitable organs so I was scared, but also a little excited. We packed up my things and my mum drove me to the hospital. I was diagnosed with Type 1 diabetes when I was six years old, but it was while I was at university around 10 years ago that the kidney failure happened. I had to quit all of my courses, move in with my parents and be on dialysis twice a week for most of the day. Treatment took everything out of me, I was tired, felt sick, and even though I wanted to go out places, as soon as we got there I d want to go home. Dialysis takes over your whole life. I did this for a year. The nurses and doctors were fantastic. Very supportive, and they d give weekly talks to the patients while we were there. Since the operation my life has changed completely. I got married to my husband George, had Daniel, and went back to university. These are things which may never have happened without the. I now have two pancreases and three kidneys, but you d never be able to tell! Waiting for that call Locating a donor pancreas and kidneys, and coordinating the care of a diabetic patient is a complex role, which at Addenbrooke s belongs to specialist nurses Stephanie Smith and Gail Defries: As pancreas coordinators, we are the patient s key contact from the moment they are referred to Addenbrooke's for a. It can be a great strain waiting for that call, a call that could come at any time or could be another 18 months away. It s really satisfying to be able to call our patients and say you have a for them after they have been living in suspense for so long. It is also a special job because we get to see them recover from this big operation and then lead a normal, active life free from this debilitating illness. When you have patients with such complex and specialist needs, it is vital that they have quick access to a person with specialist knowledge at the end of the phone. This makes our roles crucial. We help people adjust to their new lives, which include the fact that their new organs are the result of a wonderful gift given by a stranger s loved ones. Addenbrooke s on top for life-changing pancreas Page 5
A lot of plumbing and sewing Transplant surgeons at Addenbrooke s perform between 20 and 30 combined kidney and pancreas operations a year, with the delicate nature of the pancreas making this procedure a particularly complex one. Consultant surgeon Professor Christopher Watson said: There s a lot of plumbing involved in ing kidneys and a pancreas at the same time. There are nine pieces of sewing to get right, and in total the operation usually takes between six and eight hours to complete. In addition to the time, the pancreas is a very sensitive organ which is prone to clotting and inflammation, so it has to be handled very carefully. The results for patients, though, are life-changing. Imagine having to give yourself an injection of insulin before every meal, and check your sugars regularly by jabbing your fingers. You then find that the diabetes has damaged your sight, so taking the injections becomes even more challenging. You have to plan what you eat and when, and must avoid everything the rest of us enjoy, like sweets, chocolate and cream. Then you get a pancreas and suddenly you can eat and drink what you want, and all of the other complications that the diabetes was causing stop progressing. In a recent Picker Institute survey, Cambridge University Hospitals came out on top in many areas relating to the experience, support and management of care for those undergoing pancreas ation. Addenbrooke s is part of Cambridge University Hospitals, one of Europe s best teaching hospitals and a leading centre for organ ation. For more information on the Trust and its services, visit www.cuh.org.uk Addenbrooke s on top for life-changing pancreas Page 6