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Simultaneous pancreas and kidney transplantation is the treatment of choice for diabetes mellitus patients with associated end-stage renal disease. Limited vascular access could be encountered in patients with severe atherosclerosis, and/or severe obesity and in re-transplant patients. We describe a modified technique that facilitates simultaneous pancreas and kidney (SPK) composite graft transplantation with retroperitoneal systemic-enteric drainage for patients with limited vascular access.

Simultaneous Pancreas and Kidney Composite Graft Transplantation with Retroperitoneal Systemic-Enteric Drainage