Alquadan KF, Belal AA, Mehta R, Leghrouz M, Ibrahim H, Vrakas G, Santos AH. Simultaneous kidney and pancreas transplantation: Current trends and challenges. World J Transplant 2026; 16(1): 111064 [DOI: 10.5500/wjt.v16.i1.111064]
Corresponding Author of This Article
Alfonso H Santos, Division of Nephrology, Hypertension & Renal Transplantation, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States. alfonso.santos@medicine.ufl.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Mar 18, 2026; 16(1): 111064 Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.111064
Simultaneous kidney and pancreas transplantation: Current trends and challenges
Kawther F Alquadan, Amer A Belal, Rohan Mehta, Muhannad Leghrouz, Hisham Ibrahim, Georgios Vrakas, Alfonso H Santos
Kawther F Alquadan, Amer A Belal, Rohan Mehta, Muhannad Leghrouz, Hisham Ibrahim, Alfonso H Santos, Division of Nephrology, Hypertension & Renal Transplantation, University of Florida, Gainesville, FL 32610, United States
Georgios Vrakas, Department of Surgery, University of Florida, Gainesville, FL 32610, United States
Co-first authors: Kawther F Alquadan and Amer A Belal.
Author contributions: Alquadan K contributed to the conception and design of the work, leading the writing of the original draft, literature review, critical revision and editing, and approval of the final version of the manuscript; Belal AA contributed to the writing of the original draft, literature review, critical revision and editing, and approval of the final version of the manuscript; Mehta RV, Leghrouz M, Ibrahim I, and Vrakas G contributed revision, editing and approval of final version of the manuscript; Santos AH contributed to the conception and design of the work, literature review, critical revisions and editing, and approval of the final version of the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alfonso H Santos, Division of Nephrology, Hypertension & Renal Transplantation, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, United States. alfonso.santos@medicine.ufl.edu
Received: June 23, 2025 Revised: July 29, 2025 Accepted: October 24, 2025 Published online: March 18, 2026 Processing time: 206 Days and 14.4 Hours
Abstract
Diabetes is a widespread disease affecting millions of people, making it one of the leading causes of death in the world. It is a leading cause of cardiovascular disease and end-stage renal disease. Despite advancements in treatment, including insulin therapy and glucose monitoring devices, diabetes continues to significantly impact quality of life and current modalities do not reverse the end-organ damage associated with its progression. While traditionally indicated for type 1 diabetes, recent clinical practice refinements have made pancreas transplants available to select type 2 diabetics meeting specific criteria. These transplants are usually a part of a simultaneous kidney-pancreas transplant. However, although less frequently performed, transplants of pancreas alone or pancreas after kidney transplant are still available. For selected diabetic patients, pancreas transplants offer significant survival benefits and the improvement of cardiovascular and metabolic complications; however, they are not without risks. Complications such as bleeding, vascular thrombosis, infection, organ leak, and rejection are possible. Another challenge to pancreas transplantation is the decreasing number of procedures being performed due to decline in the volume of available high-quality allografts and resource constraints of transplant centers. Advancements in monitoring and treatment of diabetes are contributing to the decline in pancreas transplants nowadays.
Core Tip: Pancreas transplantation offers select patients with diabetes significant survival benefits alongside improvement in cardiovascular and metabolic complications. These benefits are most pronounced in patients receiving pancreas transplants as part of simultaneous kidney-pancreas transplants; however, pancreas transplants alone or pancreas after kidney transplants are also available. These surgeries carry certain risks and challenges, both medical and logistical, that have contributed to the recent decline in pancreas transplantation.
