Dec 2, 2013

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Interviewer: A lot of people with Type 1 diabetes believe that the insulin shots and a pump is enough, but there might actually be a better option, a pancreas transplant. We're with Dr. Paul Campsen, Surgical Director of Pancreas Transplant Surgery with the University of Utah. That option is pancreatic surgery.

Dr. Paul Campsen: That's correct. Right now we do pancreas transplants for Type 1 diabetics. Type 1 diabetics can't survive without insulin, so they give themselves shots and they can administer this sometimes through am insulin pump which is a very good way to keep them alive. The control that they get from that is not a replacement for the human organ, the pancreas. That's where the pancreas transplant comes into play in the sense that you can help yourself stay alive just like dialysis helps with kidney transplant, or with failure. A pancreas transplant gives you back the human organ that you actually need.

Interviewer: Plus, also a better quality of life.

Dr. Paul Campsen: A much better quality of life. Over the long term the pancreas transplant itself is completely correcting the diabetes, so any of the sequelae of diabetes, whether it be peripheral vascular disease, damage to your eyes, damage to your nerves, damage to your coronary arteries, all of that stuff is stopped with a pancreas transplant.

Interviewer: Not with the insulin shots or the pump?

Dr. Paul Campsen: No, I think that the insulin helps a lot. It slows down the damage. Obviously it literally saves their lives by giving them insulin, but it doesn't stop the diabetes because you're still a diabetic. The pancreas produces a variety of different enzymes and secretes many things that actually help the body including insulin, also glucagon, which keeps the sugars from going too low which can be life threatening, and any of the pancreatic enzymes that help with digestion. None of that' s given with the insulin pump. When you replace the pump with a human pancreas you get all of those benefits.

Interviewer: It sounds like a great solution. Why aren't more people doing it? Is it a dangerous surgery or is it fairly safe?

Dr. Paul Campsen: The diabetics who come to us hate their diabetes so much and they're so scared by it, and their so scared by brittleness of their, meaning they go too high with their sugar or too low, that they would do almost anything not to have to use insulin anymore, but they're scared because surgery is a big deal. The vast majority do very well with this surgery. It's very safe. They stay in the hospital for about a week afterwards, but the moment that they leave surgery they're not a diabetic anymore.

Interviewer: That's pretty amazing, isn't it?

Dr. Paul Campsen: It is pretty amazing. Many of the patients that come to us, their diabetes has also ruined their kidneys, so they're on dialysis at the same time. We'll do a simultaneous pancreas and kidney transplant. The moment that they leave the surgery the next morning they're cured of their diabetes and they're cured of the their renal failure and they're not on dialysis. The other thing that's very interesting in these patients is if you just give them a kidney transplant their Type 1 diabetes will still attack the kidney transplant.

Interviewer: It just kills that organ.

Dr. Paul Campsen: That's exactly right. The pancreas transplant added on top, because it cures the diabetes, actually protects the kidney transplant. Then both organs survive much longer.

Interviewer: Who would be a good candidate for this type of surgery?

Dr. Paul Campsen: I think anybody who has Type 1 diabetes. We're talking about unfortunate people who were diagnosed with diabetes probably before they were 20. We'd like to see these patients well before they get into their 30's. The earlier we see them the better.

Interviewer: OK. What are your final thoughts for somebody that has Type 1 diabetes and is a little on the fence?

Dr. Paul Campsen: I think basically this is a safe surgery. Coming and seeing us doesn't mean we're going to trap you and give you the surgery, but it's something where we can talk about it and see if this is the right surgery for you. If it is, we can cure your diabetes. If you have kidney problems we'll take care of those too.

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