This pilot study aims to validate the use of vascularised donor-derived sentinel skin flaps for diagnosing rejection in pancreas transplantation. The aim of the study is to investigate the use of sentinel skin flaps in clinical practice and assess whether rejection occurs concordantly or discordantly between the skin flap and the transplanted abdominal organs. If successful, sentinel skin may allow improved immune surveillance and thereby facilitate earlier treatment of rejection with subsequent improvements in allograft survival and patient morbidity.

Inclusion Criteria:

• Recipient of a pancreas transplant (SPK or PTA)
• Participant is willing and able to give informed consent for participation in the study
• Male or Female, aged 18 years or above

Exclusion Criteria:

• Patient does not have a patent ulna artery in either forearm
• Recipient of an enterically drained PTA
• Patient has received any investigational medical drug within 30 days of transplantation
• Patient is not willing to return to Oxford for all clinical follow-up for 12 months
• Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the study, or may influence the result of the trial, or the participant's ability to participate in the study.