title: [Simultaneous pancreas and kidney transplantation].
abstract: OBJECTIVE
  To perform a State of The Art about the different aspects of pancreas transplantation such as indications, technical features, immunosuppressive strategies and outcomes of simultaneous pancreas-kidney transplantation.
  
  
  METHODS
  An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH) : « pancreas transplantation; kidney transplantation; simultaneous pancreas-kidney transplantation; immunosuppression ». Publications obtained were selected based on methodology, language, date of publication (last 20 years) and relevance. Prospective and retrospective studies, in English or French, review articles; meta-analysis and guidelines were selected and analyzed. This search found 2736 articles. After reading titles and abstracts, 23 were included in the text, based on their relevance.
  
  
  RESULTS
  These last few years, considerable progresses were done in optimizing indication for pancreas transplantation, as well as surgical improvement and a better used of immunosuppression. In the first part of this article, demographics, indication and pre-transplant evaluation will be described. The different techniques of procurement, preparation and transplantation will then be discussed. Finally, the results and outcomes of pancreas transplantation will be reported.
  
  
  CONCLUSIONS
  Despite its morbidity, pancreas transplantation is the optimal treatment of end stage renal disease in diabetic patients under 55. Long-term results and quality of life improvement after pancreas transplantation are excellent.
  
  
  METHODS
  NA.
authors.affiliation: Service d'urologie et de chirurgie de la transplantation, HCL, hôpital E.-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 03, France; Université Claude-Bernard Lyon 1, 69622 Lyon, France. Electronic address: lionel.badet@chu-lyon.fr.
authors.forename: L
authors.initials: L
authors.lastname: Badet
authors.affiliation: Service d'urologie et de chirurgie de la transplantation, HCL, hôpital E.-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 03, France.
authors.forename: X
authors.initials: X
authors.lastname: Matillon
authors.affiliation: Service d'urologie et de chirurgie de la transplantation, HCL, hôpital E.-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 03, France.
authors.forename: R
authors.initials: R
authors.lastname: Codas
authors.affiliation: Service d'urologie et transplantation rénale, CHU de Nantes, 44000 Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Branchereau
authors.affiliation: Service d'urologie et transplantation rénale, CHU de Nantes, 44000 Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Karam
authors.affiliation: Service d'urologie, hôpital européen Georges-Pompidou, université Paris-Descartes, 75015 Paris, France.
authors.forename: M-O
authors.initials: MO
authors.lastname: Timsit
authors.affiliation: Service d'urologie et transplantation rénale, université de Montpellier, CHU de Montpellier , 34000 Montpellier, France.
authors.forename: R
authors.initials: R
authors.lastname: Thuret
authors.affiliation: Service d'urologie et transplantation rénale, Inserm URM 1098, université de Franche-Comté, CHRU de Besançon, 25000 Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Kleinclauss
authors.affiliation: Association pour la transplantation de pancréas et d'îlots pour le diabète, France.
mesh_terms: D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D016035:Pancreas Transplantation / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome
keywords: Diabetes; Diabète; Kidney transplantation; Pancreas transplantation; Transplantation pancréatique; Transplantation rénale