Pancreas and pancreas-kidney transplantation.

Pancreas transplantation consistently results in an insulin-independent normoglycemic state in insulin-dependent diabetic recipients. Registry data show insulin independence is achieved in 80% of simultaneous kidney and pancreas recipients, more than 70% of pancreas after kidney recipients, and more than 60% of nonuremic pancreas transplant alone recipients. Advances in immunosuppression and careful monitoring for rejection in conjunction with biopsies are largely responsible for improved results. However, complications do occur, and improvements in surgical technique and patient care continue to evolve.