Trasplante de Páncreas

Trasplante de Páncreas

Apr 17, 2018, 12:06 PM
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Devolviendo calidad y cantidad de vida a los pacientes diabéticos
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    Programa

    El trasplante de páncreas es la mejor alternativa terapéutica para pacientes diabéticos insulino-dependientes, cuyo tratamiento tradicional ha fallado, y/o han desarrollado insuficiencia renal, ofreciéndoles una mejora significativa en su calidad y cantidad de vida.

    El programa de trasplante de páncreas de Clínica Santa María está conformado por un equipo multidisciplinario de profesionales, con vasta experiencia en trasplante de órganos, lo que ha permitido ofrecer esta alternativa terapéutica a pacientes de todo Chile, provenientes tanto del sistema de salud privada como pública.

    Se trata además del programa número uno en el país, en cuanto a volumen de pacientes trasplantados y de lista de espera. El compromiso es seguir ofreciendo excelentes resultados cada vez a más pacientes.

    JAVIER    CHAPOCHNICK FRIEDMANN

    “El trasplante de páncreas es la mejor alternativa para mejorar la calidad y cantidad de vida a personas diabéticas insulino-dependientes, cuyo tratamiento tradicional ha fallado y/o han desarrollado insuficiencia renal. El programa de Clínica Santa María es el número uno en el país, en cuanto a volumen de pacientes trasplantados y de lista de espera. Ofrecemos esta alternativa a pacientes de todo el país tanto del sistema de salud privada como pública”.

    Dr. Javier Chapochnick, médico jefe Programa de Trasplante de Páncreas.
        derivación
    Enfermeras coordinadoras
     

    Quiénes lo requieren

    Para someterse a este procedimiento, la persona tiene que presentar alguna de las siguientes condiciones:

    • Diabetes tipo 1 y ser candidato a un trasplante de riñón.
    • Diabetes tipo 1 y con falla renal temprana.
    • Diabetes tipo 1 y haber recibido un trasplante renal y gozar de un buen funcionamiento de ese injerto.
    • Diabetes tipo 1 sin falla renal, pero con diabetes severamente inestable.
    • Algunos pacientes seleccionados con diabetes tipo 2 no obesos.

    El paciente debe ser evaluado por el médico especialista y será necesario realizarse exámenes de laboratorio, imágenes y un chequeo cardiológico. Una vez completada esta etapa, la situación de cada persona es discutida por los integrantes del comité de trasplante para decidir si es apto o no.

    Preguntas frecuentes

    ¿Quiénes son candidatos para someterse a un trasplante de páncreas?

    Las personas que tienen diabetes tipo 1 con falla renal, personas con diabetes tipo 1 que ya han tenido un trasplante renal o con diabetes tipo 1 sin falla renal con diabetes severamente inestable. También quienes tienen diabetes tipo 2 con un índice de masa corporal menor de 28.

    No pueden someterse a esta intervención pacientes con enfermedad cardiovascular y pulmonar avanzada, con neoplasias y/o infecciones activas, obesos mórbidos, personas que no sean capaces de entender y/o cumplir con el manejo postoperatorio o con abuso de sustancias activas.

    ¿En qué me beneficia el trasplante de páncreas?  

    El trasplante estabiliza los niveles de glucosa sin necesidad de usar insulina y reduce las complicaciones a largo plazo de la diabetes. Revierte los daños producidos por en los riñones y mejora significativamente la calidad y cantidad de vida del paciente. 

    ¿Cuáles son los riesgos de esta cirugía? 

    El trasplante de páncreas tiene los riesgos propios de una cirugía: Sangrado, infección, trombosis de alguno de los órganos, rechazo, requerir una reoperación, hernias, entre otros. Sin embargo, en aquellos pacientes que se consideran buenos candidatos, los potenciales beneficios son significativamente mayores a los riesgos asociados. 

    ¿Cuál es la preparación que se debe tener antes del trasplante? 

    Una evaluación por el equipo multidisciplinario que determinará si el paciente se beneficiará con el trasplante y si es buen candidato. Se deberá realizar una serie de exámenes de laboratorio e imágenes, además de un chequeo cardiovascular. 

    ¿Qué cuidados hay que tener después del trasplante? 

    Todos los pacientes después del trasplante requieren usar drogas inmunosupresoras (antirechazo) por el resto de su vida y mantener los controles periódicos con el equipo de trasplante. Al estar inmunosuprimidos, deben evitar el contacto con personas que estén enfermas. 

    ¿Cómo cambiará la vida después del trasplante?

    Ya no se requerirá continuar con dieta ni insulina, mejorará el nivel de energía y calidad de vida. Si la persona se dializaba, ya no necesitará apoyo dialítico después de la intervención. 

    ¿Cuán frecuente serán los controles?

    Durante el primer mes, tres veces a la semana, el segundo dos, el tercer mes una vez y así sucesivamente. 

    ¿Cuánto tiempo dura la hospitalización?

    Entre 10 y 12 días.  

    ¿Cuándo se puede volver a las actividades habituales?

    Si es un trasplante satisfactorio sin mayores complicaciones, a los tres meses. 

    ¿Qué tan importante es el apoyo de amigos y familiares?

    Es fundamental en el pre y postrasplante. Es necesario que los pacientes preparen un ambiente de apoyo y de ayuda para el manejo posoperatorio. 

    ¿Cómo es el financiamiento de este tipo de trasplante? 

    El Programa de Trasplante de Páncreas-Riñón de Clínica Santa María cuenta con convenios tanto con Isapres y Fonasa. Cada caso es evaluado por el equipo de trasplante y por el área financiera, para garantizar la cobertura de la cirugía y de las drogas inmunosupresoras.

    Para los pacientes del sistema público existe un plan en que la evaluación antes de la intervención y el seguimiento postrasplante a largo plazo sea realizado en el sistema público, mientras que la cirugía y postoperatorio inmediato en Clínica Santa María. 

     

    Postoperatorio

    Después de la cirugía se traslada al paciente al Centro de Pacientes Críticos, donde permanecerá entre 10 a 15 días. En este lugar es visitado diariamente por los miembros del equipo de trasplante, quienes evaluarán la condición clínica, analizarán sus exámenes de laboratorio e imágenes y ajustarán las dosis de los medicamentos.

    Durante la hospitalización, el equipo de trasplante instruirá respecto al uso de medicamentos y cuidados que requerirá esta nueva condición de trasplantado. La enfermera coordinadora realizará esta educación y además programará las visitas de control ambulatorio.

    Posteriormente, y si el médico tratante lo determina, se dará el alta. Una vez finalizada la hospitalización, se deben asistir a controles periódicos con el equipo de trasplante.

    Durante los primeros meses después del trasplante se está más susceptible a las infecciones o a un posible rechazo. Para evitar cualquier tipo de complicación habrá que seguir y cumplir con todas las indicaciones del médico tratante.