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Optimal glycemic control in kidney transplant recipients with diabetes is associated with improved morbidity and better patient and allograft survival. Transplant options for patients with diabetes requiring insulin therapy and chronic kidney disease who are suitable candidates for kidney transplantation should include consideration of β-cell replacement therapy: pancreas or islet transplantation. International variation related to national regulatory policies exists in offering one or both options to suitable candidates and is further affected by pancreas/islet allocation policies and transplant waiting list dynamics. The selection of appropriate candidates depends on patient age, coexistent morbidities, the timing of referral to the transplant center (predialysis versus on dialysis) and availability of living kidney donors. Therefore, early referral (estimated glomerular filtration rate

Original publication




Journal article


Am J Kidney Dis

Publication Date





418 - 428


chronic kidney disease (CKD), diabetes mellitus, hypoglycemia unawareness, kidney transplantation, pancreas after kidney transplantation (PAK), review, simultaneous islet-kidney transplantation (SIK), simultaneous pancreas-kidney transplantation (SPK), β-cell replacement therapy, Diabetes Mellitus, Type 1, Global Health, Graft Survival, Humans, Kidney Diseases, Kidney Transplantation, Living Donors, Morbidity, Postoperative Complications, Transplantation, Homologous