Sinde the introduction of the bladder drainage technique, the number of pancreas transplants performed has now reached 1000/year worldwide. Most of these transplants have been performed in the United States. In contrast, the number of pancreas transplants performed in the Eurotransplant community has remained at a low level for several years. The results of a consecutive series of 20 simultaneous pancreas/kidney grafts (SPK) performed between June 1994 and October 1995 demonstrate that high graft function rates of 83.5% for pancreas and kidney grafts can be achieved. Therefore SPK can be recommended as a standard procedure for patients with insulin-dependent diabetes mellitus and end-stage renal disease in Germany, too.