Patient selection criteria for simultaneous pancreas-kidney transplantation should include:

A. Type I diabetes mellitus.

D. Renal dysfunction with a creatinine value greater than 3.0.

E. Minimal extrarenal morbidity related to diabetes.

DISCUSSION: Simultaneous pancreas-kidney transplantation should be reserved for patients with Type I, juvenile, insulin-dependent diabetes mellitus. Although patients with Type II diabetes could potentially be helped, these older patients generally are not in good condition for simultaneous pancreas-kidney transplantation, nor are they reliably cured. In order to reliably monitor renal transplant function, the pretransplant creatinine value should be above 3, but the patient must not necessarily be on dialysis. To achieve good long-term results with pancreas-kidney transplantation it is appropriate to select patients with minimal extrarenal morbidity related to their diabetes.