I had a pancreas only transplant in 2005. At that time my chronic kidney disease (CKD) was only mild - moderate and a kidney transplant was not recommended. Fast forward to 2016. My kidney function had decreased and my pancreas function was not as good as it once was. I went through pre-transplant evaluation this time for simultaneous pancreas kidney transplant. I was approved for kidney transplant but was told that pancreas transplant was not necessary. I’ve been looking for a living kidney donor ever since. Now 7 years later neither the pancreas or kidney function are great. I’m still interested in SPK but when I had a pre- transplant review this past March I was told that I’m too old. I’m 66 and apparently there is an arbitrary 65 cut off. I think my quest for SPK lost ground 2020 - 2023 during the worst of the pandemic years and I aged out! My point is transplants are a big deal. Multiple transplants even more so. Do whatever research you feel you need to and pick a transplant center you feel you can trust and will work with you as an individual. Take into account pre-transplant work up, the transplant itself and follow up. My transplant in 2005 was at a different center than what I’m working with now (Mayo). I heartily recommend Mayo (any of the main three) because I think it is advantageous to extend the network across the country. The stellar Mayo reputation precedes them.