Pancreas after kidney (PAK) transplantation--first case in Poland

Transplantation of pancreas is a generally accepted treatment option for patients with type 1 diabetes mellitus. This procedure restores physiological insulin secretion, resulting in long-term normoglycemia and preventing complications of diabetes. One of the therapeutic possibilities is pancreas after kidney transplantation (PAK) for patients with previous successful kidney transplantation. There is evidence that patient and kidney graft survival is higher in PAK compared with diabetic recipients of kidney or pancreas alone (PTA). We report a case of pancreas after kidney transplantation in a 38 year-old male with type 1 diabetes mellitus of 21 year duration. One year before PAK he received cadaveric kidney transplant. Pancreatic graft was placed on the left side of the pelvis and enteric drainage was used. Immunosuppression consisted of antithymocyte globulin (ATG), daclizumab, tacrolimus, mycophenolate mofetil, and steroids. Ten months after surgery the patient stays normoglycemic, insulin-independent with good kidney function (Cr-1,5 mg/dl).