Results with combined kidney and paratopic segmental-pancreas transplantation.

Rehabilitation and quality of life after combined pancreas and kidney transplantation was assessed in 15 previously diabetic patients in renal failure and compared with 11 diabetic patients in renal failure transplanted with a kidney only. The paratopic segmental-pancreas-grafting technique, which allows physiologic insulin delivery into the portal venous system, was used in 13 patients; 2 patients received a heterotopic segmental-pancreas graft, resulting in systemic insulin delivery. A kidney was transplanted heterotopically in all cases. Mean age, duration of diabetes, retinopathy, neuropathy, mortality, infection rate, and immunosuppressive treatment did not differ significantly between the groups. Diabetic patients with only kidney transplants had difficulties adjusting to their diabetes, which may be partly due to the immunosuppressive treatment. The quality of life only marginally improved. In contrast, patients with a combined pancreas-kidney graft achieved full rehabilitation within a short time.