Simultaneous pancreas-kidney transplantation

Abstract In the past 50 years nearly 50,000 pancreas transplants have been performed worldwide. Simultaneous pancreas kidney transplant (SPK) is the most common form of pancreatic transplantation, representing approximately two-thirds of the total pancreas transplant activity. It is the only therapy capable of restoring both renal function and long-term insulin independence in a single intervention. Clinical outcomes are well documented: when successful, SPK is associated with prolonged life expectancy and various degrees of improvement/stabilization of chronic complications secondary to prior poor glycemic control. However, the surgery is burdened by significant morbidity and mortality rates. Furthermore, recipients face the risks of life-long immunosuppression. Hence SPK is indicated in a selected cohort of relatively fit insulin-dependent diabetic patients with end-stage renal failure.