Simultaneous pancreas-kidney transplantation at the Ohio State University Medical Center.

Simultaneous pancreas-kidney transplantation is possible in a large number of Type I diabetics with excellent patient and graft survival. Diabetic patients are prone to coronary artery disease (CAD) which remains the most common cause of death in both the pre- and posttransplant periods. Exclusion of significant CAD and/or cardiac dysfunction in the potential recipient is necessary. At The Ohio State University, one-year patient, pancreas and kidney graft survival rates were 92%, 80%, and 84%, respectively. Acute rejection following simultaneous pancreas-kidney transplantation remains a major problem but has been positively affected by newer agents. Enteric conversion is needed in less than 10% of the patients over a period of 53 months. Prospective studies comparing primary enteric drainage and bladder drainage are needed to determine the best technique, as well as immunosuppressive regimens.