Combined kidney and pancreas transplantation.

Diabetes is the leading cause of end-stage renal disease in the United States. Combined kidney and pancreas transplantation is a safe and effective treatment option for diabetic nephropathy. During the past decade, pancreas transplants had improved outcomes as a result of improvements in pancreas recovery and preservation, the surgical procedure, immunosuppressive regimens, and immunologic monitoring. Current 1-year patient and graft survival rates are 90% and 80%, respectively, and evidence is accumulating that improvements occur in microvascular and neuropathic complications as well. Successful outcomes of kidney and pancreas transplantation are due in large part to careful nursing assessment, diagnosis, intervention, teaching, and discharge planning.