Publication Name	World Journal of Transplantation
Manuscript ID	119146
Country	India

Category	Transplantation
Manuscript Type	Opinion Review
Article Title	Phase-specific intraoperative glycemic control in simultaneous pancreas-kidney transplantation
Manuscript Source	Invited Manuscript
All Author List	Pranjal Kashiv, Manish Ramesh Balwani, Priyanka Tolani, Amit Pasari, Khushboo Saxena and Vivek B Kute
Funding Agency and Grant Number
Corresponding Author	Vivek B Kute, Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, Gujarat, India. drvivekkute@rediffmail.com
Key Words	Simultaneous pancreas-kidney transplantation; Intraoperative glycemic control; Glycemic variability; Immunothrombosis; Ischemia-reperfusion injury; Metabolic stewardship
Core Tip	Simultaneous pancreas-kidney transplantation (SPKT) represents a uniquely vulnerable metabolic state in which abrupt endocrine recovery occurs under conditions of ischemia-reperfusion injury and intense perioperative stress. In this review, we highlight the importance of treating intraoperative glycemia as a dynamic biological signal rather than a static safety parameter. A phase-specific approach to intraoperative glycemic control reframes anesthetic management as metabolic stewardship, emphasizing anticipation of predictable physiologic transitions, minimization of glycemic variability, and protection of the pancreatic microcirculation at reperfusion. Aligning glucose management with graft biology may reduce early immunothrombotic and infectious risk and represents an important, pragmatically implementable advance in SPKT care.
Citation	Kashiv P, Balwani MR, Tolani P, Pasari A, Saxena K, Kute VB. Phase-specific intraoperative glycemic control in simultaneous pancreas-kidney transplantation. World J Transplant 2026; In press

Received	2026-01-20 01:04
Peer-Review Started	2026-01-20 01:05
First Decision by Editorial Office Director	2026-02-13 07:36
Return for Revision	2026-02-13 07:36
Revised	2026-02-18 20:11
Publication Fee Transferred
Second Decision by Editor	2026-04-01 02:41
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-01 08:09
Articles in Press	2026-04-01 08:09
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3230 (online)
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