Kidney-Pancreas Transplant: Who Qualifies, Surgery, Recovery and Outcomes
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is a kidney-pancreas transplant?
A kidney-pancreas transplant is surgery that gives a person a new kidney and a new pancreas at the same time, usually from the same deceased donor. It's for people who have kidney failure and type 1 diabetes. Most people no longer need dialysis, and many no longer need insulin. About 97% of people are alive one year later. [1]
What the research says
The new pancreas gives better blood sugar and cholesterol than a kidney alone. In 15 studies of people with type 1 diabetes (564 kidney-pancreas and 419 kidney-only recipients), HbA1c was 2.61 percentage points lower and total cholesterol, triglycerides and LDL were also lower after a kidney-pancreas transplant. Rates of heart disease, stroke and leg artery disease after transplant were not different between the two groups. (Choksi et al., Diabetologia, 2026) [2]
Blood clots are the main early threat to a new pancreas. Across 63 studies, clots formed in 1,127 of 15,936 whole deceased-donor pancreas transplants (7.07%), and the pancreas was lost in 83.3% of the cases where a clot was reported. (Blundell et al., Clinical and Applied Thrombosis/Hemostasis, 2020) [3]
Key takeaways
A kidney-pancreas transplant, also called a simultaneous pancreas-kidney (SPK) transplant, replaces the work of a failed kidney and a pancreas that no longer makes insulin. [1]
It is mainly for people with kidney failure and type 1 diabetes; some people with type 2 diabetes may also qualify. [1]
The average wait is about 24 to 36 months, and the pancreas always comes from a deceased donor. [1]
Surgery takes four to eight hours, and most people stay in the hospital 8 to 12 days. [1]
Anti-rejection medicine is needed for life, and about 80% of people stay free of insulin and dialysis for at least one year. [1]
Who needs a kidney-pancreas transplant?
This transplant is for people who have kidney failure and type 1 diabetes. Some people with type 2 diabetes may also be eligible. Having both conditions does not automatically make someone a candidate. [1]
A transplant team checks whether the surgery is safe and likely to work for you. The evaluation looks at: [1]
Your overall health and medical history, including any history of cancer
Smoking or substance use
A physical exam and a psychological exam
Tests of your kidneys and pancreas
Tests of your heart, lungs and bladder
The main stages from evaluation to recovery.
How does the waiting list work?
In the United States, about 800 to 900 kidney-pancreas transplants are done each year, and about 1,200 to 1,500 people are waiting for one. [1]
A kidney can come from a living or a deceased donor, but a pancreas can only come from a deceased donor. Most combined transplants use both organs from the same deceased donor. [1]
The average wait is about 24 to 36 months. People with less common blood or tissue types may wait longer. Organs go to the best-matched person based on: [1]
Blood type
Tissue type
Crossmatch (a blood test that checks whether your immune system would attack the donor organs)
Time spent on the waiting list
Once the organs are removed from the donor, the transplant must happen within 12 hours. [1]
What happens during a kidney-pancreas transplant?
The surgery is done under general anesthesia, so you are asleep. The main steps are: [1]
The new kidney is usually transplanted first. Your own kidneys are typically left in place.
The new pancreas is placed in the lower right part of your abdomen.
The pancreas is connected to nearby blood vessels and to a small segment of donor small bowel. Your own pancreas is usually left in place.
The new organs should start working within a few hours.
Where the new kidney and pancreas are placed.
Kidney-pancreas transplant at a glance
Item | Typical detail |
Anesthesia | General (you are asleep) |
Operating time | Four to eight hours |
Donor | Usually one deceased donor for both organs |
Your own organs | Usually left in place |
Hospital stay | 8 to 12 days, up to about one month for some people |
Sources: [1]
What are the benefits?
A successful kidney-pancreas transplant can give you: [1]
More strength, stamina and energy
Better day-to-day living and quality of life
Freedom from dialysis schedules, if you needed dialysis before
Normal blood sugar, usually with no more insulin injections
What are the risks?
A combined transplant carries a higher risk of surgical problems than a kidney transplant alone. The main concerns are infection and rejection. [1]
Risk | What it means |
Infection | Lifelong anti-rejection medicines make it easier to catch infections |
Rejection | Your immune system attacks the new kidney or pancreas |
Blood clots | Clots can block blood flow to a new organ |
Bleeding | Heavy bleeding during or after surgery |
Leak | Rarely, the bowel or bladder connection leaks and needs another operation |
Sources: [1]
What is recovery like?
Expect to stay in the hospital for about 8 to 12 days, and sometimes up to about a month. After you go home, you take immunosuppressants (anti-rejection medicines) for the rest of your life and have regular check-ups and tests so your team can watch how the new organs are working. [1]
When to call your transplant team
Contact your care team right away if you notice: [1]
Fever
Pus or fluid draining from the incision
Tenderness or soreness at the surgery site
Pain when you pee
What is the outlook after a kidney-pancreas transplant?
Average survival and success after a kidney-pancreas transplant.
You have about an 80% chance of needing no insulin or dialysis for at least one year after surgery, and about a 70% chance over the next five years. [1]
US national data from 2020 show that 97.14% of people were alive one year after a kidney-pancreas transplant, 92.7% after five years and 79.1% after 10 years. [1]
Can you have a pancreas transplant without a kidney?
Yes, in some cases. Some people have a pancreas transplant on its own, and others get a kidney first and a pancreas later. Complication rates are similar, but long-term success is lower than with a combined transplant, although newer medicines and better tissue matching are helping. [1]
Conclusion
A kidney-pancreas transplant treats two problems with one operation: it replaces a failed kidney and restores the body's own insulin. For many people with type 1 diabetes and kidney failure, it means life without dialysis and insulin injections.
The trade-off is major surgery, a long wait for donor organs and lifelong anti-rejection medicine. Talk openly with your transplant team about your own risks and what you can expect.
Keep learning: Read our guide to kidney transplant on its own, or learn how dialysis works while you wait.
FAQ
What is a kidney-pancreas transplant?
It is surgery that transplants a new kidney and a new pancreas at the same time, usually from one deceased donor. It is also called a simultaneous pancreas-kidney (SPK) transplant.
Who is a candidate for a kidney-pancreas transplant?
People with kidney failure and type 1 diabetes are the main candidates. Some people with type 2 diabetes may also qualify after a full evaluation.
How long is the wait for a kidney-pancreas transplant?
The average wait is about 24 to 36 months. Less common blood or tissue types can make the wait longer.
Can a living donor give a pancreas?
No. A kidney can come from a living or deceased donor, but the pancreas comes only from a deceased donor.
How long does kidney-pancreas transplant surgery take?
The surgery usually takes four to eight hours under general anesthesia.
How long will I stay in the hospital?
Most people stay 8 to 12 days, but some stay up to about one month.
Will I still need insulin after a kidney-pancreas transplant?
Most people no longer need insulin. About 80% stay free of insulin and dialysis for at least one year.
Are my own kidneys and pancreas removed?
Usually not. The new organs are added, and your own kidneys and pancreas are typically left in place.
What are the risks of a kidney-pancreas transplant?
The main risks are infection and rejection. Blood clots, bleeding and, rarely, a leak at the bowel or bladder connection can also happen.
What is the survival rate after a kidney-pancreas transplant?
US data show about 97% of people alive after one year, 93% after five years and 79% after 10 years.
How do I prepare for a kidney-pancreas transplant?
Before you are placed on the waiting list, the transplant center evaluates your overall health, including smoking or substance use, and does a psychological exam and tests of kidney and pancreas function. Once listed, be ready to act quickly, because the surgery needs to happen within 12 hours of the organs being removed from the donor [1].
Does a kidney-pancreas transplant hurt, and what anesthesia is used?
You are asleep for the entire surgery under general anesthesia, so you do not feel the operation. After you go home, tenderness or soreness at the surgery site is a reason to contact your transplant team [1].
When should I call my doctor after a kidney-pancreas transplant?
Contact your transplant team right away if you have a fever, pus or fluid draining from the incision, tenderness or soreness at the surgery site, or pain when you pee [1].
Related Reading
Pancreas Transplant: Who It's For, Surgery and Recovery explains pancreas transplants for severe diabetes.
References
Cleveland Clinic. Kidney-Pancreas Transplant: Procedure, Risks & Recovery. Cleveland Clinic. Last updated August 19, 2024. https://my.clevelandclinic.org/health/procedures/4754-kidney-and-pancreas-transplant
Choksi H, Klein Nulend R, Cooper T, et al. Metabolic and macrovascular outcomes following simultaneous pancreas-kidney transplantation and kidney transplantation alone in recipients with type 1 diabetes mellitus: a systematic review and meta-analysis. Diabetologia. 2026;69(11):3196-3209. PMID 42667390. https://doi.org/10.1007/s00125-026-06843-x
Blundell J, Shahrestani S, Lendzion R, et al. Risk factors for early pancreatic allograft thrombosis following simultaneous pancreas-kidney transplantation: a systematic review. Clin Appl Thromb Hemost. 2020;26:1076029620942589. PMID 33052066. https://doi.org/10.1177/1076029620942589
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own situation before making decisions about your health. If you think you have a medical emergency, call your local emergency number right away.
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