Relative contraindications to pancreas-kidney transplantation |
Age <18 or >60 years |
BMI >30 to 35 kg/m2 |
Daily insulin requirement >1 unit/kg |
Insulin requiring for <3 years |
Left ventricular ejection fraction <40% |
Recent myocardial infarction or stroke |
Pulmonary artery systolic pressure >50 mmHg (confirmed by right heart catheterization) |
Active tobacco smoking (up to 1 pack/day or patient has mild smoking-related morbidities) |
History of major unilateral or bilateral extremity amputations |
Presence of aorto-iliac or aorto-bifemoral bypass graft |
Symptomatic cerebrovascular or peripheral vascular disease |
Positive thrombophilia screen or history of hypercoagulability |
Peritoneal dialysis with history of multiple prior episodes of peritonitis |
History of multiple previous laparotomies |
History of previous intra-abdominal/pelvic irradiation or multiple surgical procedures |
Severe or uncontrolled orthostasis or hypotension |
Severe or uncontrolled gastroparesis |
Presence of an ostomy, feeding tube, or chronic bladder drainage catheter |
History of previous substance abuse, psychiatric illness, or noncompliance/nonadherence |
Limited psychosocial support and resources (lives alone, relies on public transportation) |
Jehovah's Witness who refuses blood products |
Incurable chronic, active, or unresolved infection, including chronic active viral hepatitis B, uncontrolled hepatitis C, or uncontrolled HIV |
Substance use disorder (eg, alcohol, tobacco, narcotics) that is either active or within the last 6 months and has not been evaluated for or entered into a structured rehabilitation or cessation program |
Moderate to advanced cirrhosis |
Life expectancy less than 2 years because of other irreversible systemic illness or multiple comorbidities |
Not up to date with center-specific vaccination requirements |
Malignancy in the last 2 years, with the exception of cutaneous squamous and basal cell tumors, that is not in complete remission or believed to be cured |
Severe frailty, sarcopenia, deconditioning, or malnutrition |
Limited health literacy |
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