| Summary: | Background: Simultaneous pancreas-kidney transplantation (SPK) is an established therapy for diabetes mellitus (DM) patients with associated end stage renal disease. We report the initial results of SPK in our institution after qualification as transplantation program. Patients and methods: Between September 2017 and July 2018, we performed 3 SPK in type 1 diabetic patients with end-stage renal disease. All grafts were procured from brain-dead marginal donors according Pittsburg criteria. Results: The recipients were 2 men and 1 woman with a mean age of 43 ± 5.4 years. Mean time from DM diagnosis and time on dialysis were 25.7 ± 3.9 years and 19.7 ± 9.1 months. The mean age and HbA1C value of donor were 56.7 ± 0.5 years and 5.67 ± 0.05%. The pancreatic grafts were transplanted intraperitoneally in the right iliac fossa. Two patients required a relaparotomy due to arterial anastomotic hemorrhage and two patients developed acute cellular rejection. With a median follow-up of 13 (6–15) months, patient's and graft's survival rate were 100%. All patients showed HbA1C within normal range, but oral glucose tolerance test showed DM pattern in two patients at 3 months after transplantation. Conclusions: In our initial experience with SPK, mid-term grafts and patient survival appear comparable to the results reported in literature. Despite the limited availability of donors and the use of grafts from marginal donors, a quality pancreas transplantation program can be established even in a small-volume centers. Nonetheless further improvement in surgical techniques and meticulous management appear mandatory. Keywords: Simultaneous pancreas-kidney transplantation, Initial experience, Postoperative bleeding, Acute cellular rejection
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