Kidney/pancreas transplantation: a review of the current status.

KPT has become the treatment of choice for many Type I diabetics with impending or actual end-stage renal disease. The techniques of organ procurement, surgical transplantation, and postoperative management are well established. The current 1- and 3-year patient and graft survival rates are at least equal to those obtained in both diabetic and nondiabetic patients receiving kidney transplants alone. Although there is significant associated morbidity unique to the pancreas transplant, this is usually manageable without influencing the outcome. With the improvement in quality of life and the potential for arresting diabetic complications, KPT is a procedure that should be seriously considered for many Type I diabetic patients with advanced nephropathy.