Abstract
Simultaneous pancreas and kidney transplantation (SPK) represents the most effective treatment for selected patients with type 1 diabetes and end-stage kidney disease. However, SPK is a technically complex surgical procedure and is particularly challenging in patients with anatomical variations. Situs inversus abdominalis (SIA) is a rare hereditary condition in which the abdominal organs and vessels are arranged in a mirror image of standard anatomy. In this case report, we describe a successful SPK in a patient with SIA. We discuss the surgical technique in detail, especially the importance of correct pancreas graft placement to avoid dangerous complications such as vascular thrombosis.