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World J Transplant. Jun 18, 2026; 16(2): 115136
Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.115136
Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.115136
Perioperative outcomes and phase-specific intraoperative glycemic management in simultaneous pancreas-kidney transplantation: A single-center case series
Felix R Montes, Laura Gutiérrez-Soriano, Juan Carlos Kling, Department of Anesthesiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogota 111321, Colombia
Juan Diego Gutierrez-Navarro, Natalia Restrepo-Patiño, Eduardo Becerra-Zapata, Laura Peña-Blanco, Anesthesiology Research Group, Fundación Cardioinfantil-Instituto de Cardiologia, Bogota 111321, Colombia
Juan Diego Gutierrez-Navarro, Natalia Restrepo-Patiño, Rodrigo Martinez-Ardila, Nicolas Diaz-Riaño, Laura Gonzalez-Vasquez, Escuela de Medicina y Ciencias de la Salud, Colegio Mayor Nuestra Señora del Rosario, Bogota 110911, Colombia
Nathaly Ramirez-Sanchez, Luis Manuel Barrera-Lozano, Department of Transplant, Fundación Cardioinfantil-Instituto de Cardiología, Bogota 111321, Colombia
Co-first authors: Felix R Montes and Juan Diego Gutierrez-Navarro.
Co-corresponding authors: Felix R Montes and Laura Gutiérrez-Soriano.
Author contributions: Kling JC, Gutiérrez-Soriano L, Barrera-Lozano LM, and Ramirez-Sanchez N attended the cases and participated in the patient’s treatment; Gutierrez-Navarro JD, Restrepo-Patiño N, Martinez-Ardila R, Diaz-Riaño JN, Becerra-Zapata E, Peña-Blanco L and Gonzalez-Vasquez L collected data and drafted the manuscript, contributed to the literature search, developed the figures and edited the manuscript; All authors participated in discussions and critically revised the manuscript; All authors approved the final version of the manuscript. Both Montes FR and Gutiérrez-Soriano L have played important roles in the manuscript preparation as the co-corresponding authors. Gutiérrez-Soriano L contributed to the conception of the study, the development and design of the algorithm, supervised its implementation, monitored patient adherence to the algorithm, and conducted the literature search. Montes FR contributed to the critical revision of the manuscript through its different versions and was responsible for the preparation and submission of the current version of the manuscript.
AI contribution statement: Grammarly was used only for limited language polishing, including grammar, spelling, punctuation, and stylistic review. It was also used to assist with the English translation and language refinement of tables. No AI tool was used to generate the entirety or any portion of the main text of the manuscript, including the abstract, introduction, materials and methods, results, discussion, or conclusions. No AI tool participated in the design of the study, data collection, data analysis, interpretation of the results, or formulation of the conclusions. All scientific content, analyses, interpretations, and final decisions were developed, reviewed, and approved by the authors. No images, figures, or graphical elements in the manuscript were generated by artificial intelligence. The authors take full responsibility for the accuracy, integrity, and originality of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Fundación Cardioinfantil-La Cardio Institutional Review Board (No. CEIC-100-2025).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at montes.felix@hotmail.com. Participants gave informed consent for data sharing.
Corresponding author: Felix R Montes, MD, Department of Anesthesiology, Fundación Cardio
Received: October 13, 2025
Revised: November 13, 2025
Accepted: January 6, 2026
Published online: June 18, 2026
Processing time: 232 Days and 20.2 Hours
Revised: November 13, 2025
Accepted: January 6, 2026
Published online: June 18, 2026
Processing time: 232 Days and 20.2 Hours
Core Tip
Core Tip: This retrospective study introduces a structured six-phase intraoperative algorithm for metabolic control during simultaneous pancreas-kidney transplantation, defining phase-specific glycemic targets and key decision points from induction to reperfusion. Implemented in 11 consecutive cases, the algorithm proved feasible and safe, maintaining intraoperative glucose within target ranges and avoiding severe hypoglycemia. Most recipients achieved early postoperative euglycemia without exogenous insulin. Visual analysis suggested greater glycemic variability among patients with po