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[IP] kidney/pancreas transplant

This is an old email from someone who has been there done that... (ie.
not me!)
Keeping in my that I had my transplants almost 10 years ago (yippeee!)
and that things
have changed dramatically since then, I'll try my best to answer your
Doctors don't always update patients on the latest technology and
treatment plans for
newbies, so all the stuff I know dates back to 1990.

Starting with cost.  My transplant(s) is/are a combination
kidney/pancreas transplant.
Back in '90, kidney transplants were covered by Medicare and therefore
cost very little,
if anything.  Pancreas transplants were semi-experimental, ie. some
insurance plans
would cover them and some wouldn't.  Mine wouldn't, and we were told the
transplant would cost $20,0000 - a very low figure compared to what the
kidney would
have cost.  Most tx (transplant) centers that offered pancreases would
charge Medicare
for the basic expenses of the general tx experience as the kidney tx,
and then charge
the patient for the incremental costs. I am fortunate in that my
grandmother really
wanted me to have this and decided to pay for it, so I never saw an
actual bill.  The
$20,000 figure came from the pre-transplant interview with my surgeon. 
Now to the year
2000.  I'm not absolutely certain, but I think Medicare will now pay for
the pancreas
portion as well as the kidney, given that the original kidney failure
(for diabetics) is
often due to the long-term effects of diabetes.  Leaving the native
pancreas invites the
same factors to affect the new kidney; popping a new pancreas in
decreases that risk.
Also, most insurance companies (that I've been exposed to) now cover the
expenses for
kidney/pancreas transplants.

Pancreas-only transplants are
offered, or were at least talked about in 1990, but they were not
encouraged.  The tx is
not the cure-all, end-all treatment for diabetics - it's exchanging one
set of medical
conditions (chronic ones) for another.  A transplant - of any sort - is
serious stuff.
I'd rather be on insulin than immunosuppressants if my diabetes was
under control.  Both
have serious long-term consequences.  If you know of diabetics who have
long-term conditions, it could be worth investigating....  but it would
also be worth
lots of very serious thought.  Kidney-pancreas transplants, on the other
hand, are
(almost) a two-for-one bargain, with the pancreas being the bonus
option.  The need for
a kidney and pancreas implies two very important factors: (1) kidney
failure with
impending dialysis, and (2) likely-unmanagable diabetes that has already
begun wreaking
havoc on the body.  Dialysis, although a life-saving treatment, is not
fun.  Repeat, NOT
fun.  The kidney transplant fixes the kidney failure, and the pancreas
is a wonderful
preservation and preventative measure - the new pancreas produces the
insulin and
glucose control needed to stop further diabetic damage and, in 1990,
there was talk that
it actually could help with current problems.  Remember, that was 1990,
and I haven't
heard much about that since then.  The big news was that a new pancreas
could help
(mildly) reverse eye damage, which often occurs the same time as kidney
damage.  I was
lucky enough that the only known diabetic complication I had was kidney
failure, so I
personally can't speak to this - but again, it would be worth asking a
doctor if someone
were seriously considering a transplant.
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