Simultaneous pancreas-kidney transplantation is presently a well-accepted procedure for patients with type 1 diabetes mellitus and renal failure. However, experiences with combined pancreas and liver transplantation are scarce, a few data are available about the best immunosuppression for these patients. We report our experience with two patients who received a pancreas after liver transplantation for long-standing insulin-dependent diabetes mellitus, with steroid-free immunosuppression based on daclizumab, tacrolimus, and mycophenolate mofetil. Short- and long-term evolution was uneventful. Currently, both patients are insulin free with appropriate metabolic control after 12 and 6 months follow-up. Considering our preliminary results, we suggest a steroid-free immunosuppressive regimen as an option for pancreas-after-liver transplantation.

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http://dx.doi.org/10.1016/j.transproceed.2005.09.157DOI Listing

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