Challenging the paradigm: Simultaneous pancreas–kidney transplantation in type 2 diabetes mellitus
Sai Praneeth R. Perugu, Sarbpreet Singh, Deepesh B. Kenwar, Devprakash Chaudhary, Jasmine Sethi, Soham Mukherjee, Sanjay K. Bhadada, Ashish SharmaABSTRACT
Simultaneous pancreas–kidney transplantation (SPKT) is the standard of care for patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease. However, its role in type 2 diabetes mellitus (T2DM) remains debated, with some centers considering it a relative contraindication. Growing evidence supports the successful outcomes of simultaneous pancreas–kidney (SPK) in appropriately selected T2DM recipients, yielding outcomes comparable to those in T1DM. Meticulous candidate selection is crucial and should include assessment of insulin dependence, insulin resistance (insulin requirement: <1 unit/kg/day), and comorbid status (age: <55 years and body mass index: <30 kg/m 2 ). We report the outcomes of two patients with insulin-dependent T2DM with end-stage renal disease who underwent SPK at our center.