Pancreas transplantation in the setting of multivisceral transplantation

The pancreas transplant as a part of multivisceral or multiorgan transplantation has always been approached with caution because of graft pancreatitis, rejection, or technical complications. The multivisceral transplantation is a complicated process, starting from the recipient, the donor selection, the indications, the contraindications, and the postoperative management. Intestinal transplant recipients generally require more profound immunosuppression than patients receiving other solid organs because of the higher immunogenicity of the intestine. Unlike the early years of intestinal transplantation, when technical challenges and vascular events were likely to cause graft loss and patient mortality, the current most common causes of allograft dysfunction are infection and graft rejection. Unlike the early years of intestinal transplantation, when technical challenges and vascular events were likely to cause graft loss and patient mortality, the current most common causes of allograft dysfunction are infection and graft rejection.