Due to recent advances in immunosuppression and surgical technique, whole organ pancreas transplantation has become a viable treatment for select patients with insulin-dependent diabetes mellitus, the simultaneous pancreas-kidney (SPK) transplant operation is performed as a combined operation for select patients with type I diabetes mellitus.

Potential candidates for SPK transplantation include those individuals who have end-state renal disease caused by insulin-dependent diabetes and would otherwise be candidates for kidney transplantation alone. The primary benefit for these patients is correction of their abnormal glucose metabolism, allowing withdrawal from insulin therapy, as well as liberalization of diet.

In addition, there may be some benefit in preventing the progression of diabetic microangiopathy, particularly diabetic retinopathy. Patients who have not yet experienced kidney failure but have brittle diabetes with frequent episodes of ketoacidosis may also be considered for pancreas transplantation.