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Raj Patel, M.D.
UAMS Performs First Kidney-Pancreas Transplant in Arkansas Since 1990s
| The University of Arkansas for Medical Sciences (UAMS), which is the only hospital in the state performing adult liver and kidney transplants, now offers pancreas transplants.
Raj Patel, M.D., surgical director of pancreas transplantation at UAMS, successfully completed the first combined kidney-pancreas transplant in Arkansas since the 1990s on Sept. 1.
The 27-year-old patient was an insulin-dependent Type 1 diabetic on dialysis for kidney failure who had been fighting for survival since her early teens. She is now free of both insulin and dialysis and has returned to her normal activities, Patel said.
Arkansans in need of pancreas transplants previously had to leave Arkansas to have the procedure and to receive follow-up care, with the closest transplant centers located in Memphis, Dallas or St. Louis. Now, UAMS surgeons perform the transplant on the main Little Rock campus and provide preliminary and follow-up care in Little Rock and at a growing network of satellite clinics in Fayetteville, Jonesboro, Texarkana, Pine Bluff, Fort Smith and Helena-West Helena.
“UAMS is dedicated to meeting the needs of our patients and communities,” said Lyle Burdine, M.D., director of solid organ transplants. “Whenever patients have to leave the state for treatment, it creates a hardship for them and their families. We are grateful to be able to expand our services to include pancreas transplants.”
Patel said many Arkansas patients needing pancreas transplants are on Medicaid or Medicare, both of which cover the procedure.
Still, he said, UAMS expects to perform only “a handful” of the procedures. Such transplants are rare because the pancreas is “a finicky organ,” the donor criteria is very precise, and the procedure is delicate, which can lead to complications, he said. In addition, constant improvements in insulin pumps make pancreas transplants less necessary by giving diabetics better sugar control, which lessens the need for insulin and helps their kidneys last longer.
“Right now, we are only doing kidney-pancreas transplants,” Patel said, noting that dual-organ transplants from the same donor have been shown to benefit patients more than pancreas transplants by themselves.
The primary recipients will be Type 1 diabetics, though Patel said the transplants might eventually become available for Type 2 diabetics as well.
The process generally takes four to five hours and includes removing the donor organs, implanting them separately in the recipient through a single incision and restoring blood flow to the area. That was the case for the recipient of the first kidney-pancreas transplant, who was discharged a week later and whose lab results during follow-up outpatient visits “look really good,” Patel said.
He said that because the waiting list is shorter for people who need both a kidney and a pancreas transplant, as opposed to a kidney transplant alone, UAMS’ decision to start doing pancreas transplants is also helping kidney patients move more quickly up a long waiting list. The first transplant patient was on a waiting list for about a month.
Before performing pancreas transplants, UAMS had to meet stringent certification requirements by the United Network for Organ Sharing (UNOS), which administers the country’s organ procurement and transplantation network. Among the requirements are that a medical center have in place both a transplant surgeon and a nephrologist who have performed a pancreas transplant within one year.
The requirement was met with the hiring in late 2022 of Martha Michelle Estrada, M.D., a board-certified transplant/hepatobiliary surgeon. Patel, a fellowship-trained transplant surgeon who specializes in treating diseases of the kidney, liver and pancreas, said he also refreshed his training by recently assisting with a pancreas transplant.
The Scientific Registry for Transplant Recipients (SRTR), which evaluates transplant programs for the U.S. Department of Health and Human Services, recently ranked UAMS’ kidney and liver transplant programs among the highest in the nation in categories that have the largest impact on patients’ survival.
The kidney transplant program ranked third among 256 programs, while the liver transplant program ranked fourth among 149 programs.
Both received five out of five bars for the speed at which patients obtain transplants after being listed. In addition, the kidney transplant program received five bars for patient survivability one year after transplant, while the liver transplant program scored four bars for survivability one year after transplant.
UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and eight institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute, Institute for Digital Health & Innovation and the Institute for Community Health Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,485 students, 915 medical residents and fellows, and seven dental residents. It is the state’s largest public employer with more than 11,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit www.uams.edu or uamshealth.com. Find us on Facebook, X (formerly Twitter), YouTube or Instagram.###