P ancreas transplantation is a nonpharmacologic approach to glucose homeostasis in patients with diabetes associated with better self-identified health scores than insulin alone. [1][2][3] Patients with diabetes are more likely to be alive at 20 y following deceased donor simultaneous pancreas-kidney (SPK) transplant, which is a robust solution for diabetes management. [4][5][6][7][8] Pancreas transplantation is associated with higher rates of rejection-related graft loss than kidney transplantation. [9][10][11][12][13] Reports suggest that the rate of rejection within 1 y of pancreas transplantation is up to 21% and is 44% after 10 y. 12,13 As such, pancreas transplant recipients undergo routine testing of blood glucose, serum amylase, and serum lipase, which have poor sensitivity and specificity for rejection. 14 Moreover, it is important to distinguish rejection from surgical complications because treatments are diametrically opposed.

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