{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T02:02:46Z","timestamp":1780020166022,"version":"3.53.1"},"reference-count":25,"publisher":"Baishideng Publishing Group Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Transplant"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Simultaneous pancreas-kidney transplantation (SPKT), an established treatment for patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) and end-stage renal disease (ESRD), provides metabolic stabilization and improved survival. Although perioperative glycemic control is crucial for graft viability; intraoperative management remains understudied, and standardized phase-specific protocols are lacking.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To explore the feasibility, safety, and immediate outcomes of a six-phase intraoperative glycemic control algorithm for SPKT.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>This retrospective case series included 11 patients with T1DM or T2DM and ESRD who underwent SPKT at a quaternary care center between January 2024 and May 2025. All patients were managed using a six-phase institutional glycemic control algorithm that maintains intraoperative blood glucose levels within predefined targets. Data on clinical, metabolic, surgical variables; complications; and early outcomes were collected.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>In most cases, intraoperative blood glucose levels were maintained within target ranges; however variations were observed [range: 63-453 mg\/dL (3.5-25.2 mmol\/L)]. No severe hypoglycemia or ketoacidosis occurred. During the first 24 postoperative hours, seven patients (63.6%) achieved euglycemia without exogenous insulin, whereas two required transient insulin therapy. Six patients (54.5%) had postoperative complications, including thrombotic (n  = 4), infectious (n  = 2), and reperfusion syndrome (n  = 1). One patient experienced more than one event. All events were successfully managed, without graft loss, acute rejection, or in-hospital mortality.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>The phase-specific intraoperative glycemic protocol for SPKT is feasible and safe. However, prospective studies with larger cohorts are warranted to assess its long-term impact on graft survival and patient outcomes.<\/jats:p>","DOI":"10.5500\/wjt.v16.i2.115136","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T01:19:11Z","timestamp":1780017551000},"source":"Crossref","is-referenced-by-count":0,"title":["Perioperative outcomes and phase-specific intraoperative glycemic management in simultaneous pancreas-kidney transplantation: A single-center case series"],"prefix":"10.5500","volume":"16","author":[{"given":"Felix R","family":"Montes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan 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