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The treatment of patients with DM presents many challenges to care providers.2 Pancreatic transplantation in humans was first introduced in 1966 and the initial outcome was disappointing.1 However, pancreas transplantation has undergone a number of important surgical and medical advances leading to improved outcomes, particularly in recent years.1,3 The most common type of pancreas transplant is simultaneous pancreas kidney (SPK) transplantation. The procedure is usually performed in patients with insulin-treated DM, an estimated glomerular filtration rate lower than 20 mL/min/1.73m2 and good cardiovascular fitness.2,4

Simultaneous pancreas-kidney transplantation after liver transplantation: first Portuguese case report