Possible Islet Transplant Complications

So far, there have been few complications reported as a result of islet transplantation, and the incidence of complications has actually decreased over time. However, islet transplantation is a very new field. It's possible that unexpected complications will arise as the procedure becomes more common.

The following is a list of possible complications that may arise during or after transplant surgery:

• Bleeding at the site of the transplant. Excessive bleeding can require blood transfusions or, in extreme cases, another open surgical procedure to stop the bleeding.
• Blood clot in the portal vein or liver. This can decrease the blood supply to the liver, which could lead to liver failure and possibly death.
• Low blood glucose levels after the islet injection.
• Shoulder and abdominal pain. This usually resolves within two to three days.
• Infection

Rejection

Rejection occurs when the immune system recognizes the transplanted islets as foreign and attacks them. To help prevent rejection, islet transplant recipients take immunosuppressant medications to weaken the immune system. These medications must be taken on time and as prescribed in order to reduce the risk of rejection. Immunosuppressants must be taken for as long as the islets are working. There is still a possibility that the body will reject the transplanted islets. There are not many known signs of rejection in islet transplant recipients. A rise in blood sugar levels could indicate rejection. If an unexpected rise in blood sugars occurs, it should be reported to the transplant team immediately.

More About Immunosuppressants

Immunosuppressant medications can have many unpleasant side effects. Not every patient will experience every negative side effect, and some people may have no side effects at all. But it is important to know what to watch for.

Because immunosuppressants weaken the immune system, transplant patients are at increased risk for infections. Other medications will be prescribed to help prevent infections. As immunosupporessant doses are stabilized, the risk for infection goes down.

Some helpful hints to help prevent infection:

• Hand washing is the best way to prevent infection.
• Cuts or scrapes should be cleaned with soap and water.
• Do not share eating utensils or drink after another person.
• Avoid people who have infections like colds or the flu.
• Get an annual flu shot.
• Report any symptoms of infection to the transplant team right away.
• Do not keep exotic pets or birds.
• Do not wear artificial nails.

Even with the best efforts, an infection may develop. Here are some warning signs:

• Fever, chills, sore throat
• Nausea, vomiting, diarrhea
• Headache, earache, sinus drainage
• Coughing up mucus or green sputum
• Enlarged neck glands
• Pain, redness, pus, or swelling around a wound
• Painful urination
• Feeling tired, achy, or weak

Immunosuppressants increase the risk for developing certain kinds of cancer. Some helpful hints to help prevent or detect cancer:

• Always use maximum sunblock protection on the face. When exposed to the sun, wear a hat and maximum sunblock on exposed areas such as arms and shoulders. Never sunbathe or use a tanning bed.
• Have any unusual skin growths examined right away.
• For women, have an annual gynecology exam and pap smear, perform regular breast self-exams, and have an annual mammogram.
• For men, have an annual prostate exam and perform regular testicular self-exams.
• Report any suspicious skin growth, swelling or lump to the transplant team.

Cytomegalovirus (CMV) is an extremely common virus that can be serious in transplant patients. It usually causes flu-like symptoms including fever, body aches, and decreased appetite. Islet transplant patients will be tested for CMV antibodies, because during the first few months post-transplant, it's possible for CMV to reactivate. Patients are given Valcyte during the first few months following transplant to protect them from developing an active CMV infection.