My 45 year old mother-in-law (who lives in Turkey) has type 1 diabetes and has to have dialysis because her kidneys do not work properly. She is now often very weak and cannot stand up for very long. My husband (her son) and I want to help her receive the best medical treatment for her condition.

She has been told that even though her father is a good match for a kidney transplant, due to her condition, any kidney transplant would be killed by the diabetes. We understand that she would need a pancreas transplant as well as a kidney transplant. Can you please give us any medical advice you can to help her condition and thus improve her long term prospects?

In the United States, Canada, and Europe, patients are transplanted with a kidney when diabetes is the cause for the kidney failure. That does not mean that diabetes-related changes cannot recur in the transplanted kidney; they can. However, the hope is that the kidney transplant will improve health enough to allow her to improve her blood sugar control so that any recurrence would not occur or be in the distant future.

Although a pancreas would help to make her insulin-free, it is not necessarily an absolute requirement. Is it possible that her general health would not allow a surgery? If this is not the case, I would recommend you seek a second opinion for her.

JTL

[Editor’s comment: Also, see Pancreas Transplantation, at the Diabetes Monitor.

WWQ]