{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:59:40Z","timestamp":1784627980741,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Simultaneous pancreas\u2013kidney transplantation (SPK) is the preferred treatment for individuals with type\u20101 diabetes and end\u2010stage renal disease. However, a limited supply of \u201cIdeal Pancreas Donors\u201d contributed to a growing disparity between available organs and recipients. Even though SPK outcomes from pediatric donors match those from adult donors, unclear guidelines on minimum age and weight criteria for extra small pediatric pancreas donors lead to hesitancy among several transplant centers to utilize these grafts due to concerns about inadequate islet mass, technical challenges, and increased risk of allograft thrombosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This report details the successful outcomes of SPK transplantations performed at the study center between December 2021 and January 2024, using four extra small pediatric brain\u2010dead donors (ESPDs). Each donor was aged \u22645 years and weighed &lt;20\u00a0kg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All SPK recipients achieved immediate posttransplant euglycemia without requiring insulin. None of the recipients experienced graft pancreatitis, graft thrombosis, allograft rejection, or required re\u2010exploration. During a 5\u201327\u2010month follow\u2010up period, all ESPD recipients maintained optimal graft function, as evidenced by normal glucose tolerance tests and HbA1c (4.9%\u20135.2%), with 100% graft and patient survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This report examines the usage of ESPDs in SPK transplantation, highlighting their potential to expand the donor pool and reduce wait times in areas with scarce deceased organ donations, thereby increasing the number of available organs for transplantation with acceptable outcomes. Revising donor selection guidelines to reflect the diverse risk\u2013benefit profiles of waitlisted individuals is crucial to addressing geographical disparities and reducing organ discard rates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15448","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T08:51:19Z","timestamp":1725439879000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Small Donors, Big Impact: Optimizing Organ Utilization in Simultaneous Pancreas and Kidney Transplantation From Extra Small Pediatric Donors"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5804-5143","authenticated-orcid":false,"given":"Devprakash","family":"Choudhary","sequence":"first","affiliation":[{"name":"Department of Renal Transplant Surgery Post Graduate Institute of Medical Education &amp; Research (PGIMER) Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1468-9684","authenticated-orcid":false,"given":"Sahil","family":"Rally","sequence":"additional","affiliation":[{"name":"Department of Renal Transplant Surgery Post Graduate Institute of Medical Education &amp; Research (PGIMER) Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0259-5083","authenticated-orcid":false,"given":"Arun","family":"Panjathia","sequence":"additional","affiliation":[{"name":"Department of Renal Transplant Surgery Post Graduate Institute of Medical Education &amp; Research (PGIMER) Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2760-3225","authenticated-orcid":false,"given":"Bharat","family":"Bamaniya","sequence":"additional","affiliation":[{"name":"Department of Renal Transplant Surgery Post Graduate Institute of Medical Education &amp; Research (PGIMER) Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-7674","authenticated-orcid":false,"given":"Abraham","family":"Matar","sequence":"additional","affiliation":[{"name":"Department of Solid Organ Transplantation MHealth Fairview University of Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-394X","authenticated-orcid":false,"given":"Jasmine","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, PGIMER Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0718-3332","authenticated-orcid":false,"given":"Shivakumar S.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Renal Transplant Surgery Post Graduate Institute of Medical Education &amp; 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