The most prevalent disease related to pancreas in present day is diabetes mellitus (DM), where insulin production in pancreas stops. India is the diabetes capital of world and the highest number of diabetic patients live in India.
Among many complications of diabetes, the most dreaded one is diabetic nephropathy with end stage kidney disease (ESKD), where patient is dialysis dependent and needs kidney transplant to survive. This is more severe in Type 1 DM, also known as juvenile diabetes or juvenile DM, where there is no insulin production from pancreas. These patients are young patients that suffer life complications like ESKD, Hypoglycemia attacks, neuropathy, and retinopathy very early in their life, results in the early death, these young patient can be treated by pancreas transplant, where healthy pancreas from the organ donor is transplanted in the body of the patient.
As we discussed earlier pancreas transplant is indicated when the patient develops ESKD and dialysis dependent. In these patients pancreas transplant is done in combination with kidney transplant. Nearly 90% of these patients will have 5-year survival and up to 70% will survive up to 25 yrs after combined kidney & pancreas transplant.
However, the major problem in India is lack of organ donation and lack of enough pancreas for transplantation. In the USA every year nearly 1000 pancreas transplants are done, while in India a total of around 200 pancreas transplants have been done in last 10 years (2013-2023). According ICMR 2022 report more than 2.5 lakh patients are suffering from type 1 DM and approx. 10% (25000) of them needs transplant every year in India but according to NOTTO only 27 pancreas transplants done in India in 2022-2023.
In Odisha, only 3 organ donation have been done in last year, which shows how far behind we are. In Sweden a “presumed consent” for organ donation is followed that is if a patient becomes brain dead, his organs is automatically donated, however in India no such policy is there. Therefore, as a society if we can create awareness among our public for organ donation, we can save so many of young lives. To become a developed nation by 2047, we should also have a healthy society and developed mindset towards organ donation like other developed nations.
(Author: Dr. Jyotirmay Jena, Consultant - G.I. & H.P.B Surgery, Manipal Hospital, Bhubaneswar)
