Study of OmniGraft in Simultaneous Pancreas Kidney Recipients

Inclusion Criteria: 1. Male or female adult (≥18 years old) with a history of simultaneous pancreas kidney transplant between 3 months and 1 year prior to enrollment (cohort 1) or at the time of presentation for "for-cause" biopsy 2. Adults able to consent 3. Bladder or enteric drained 4. Type 1 or Type 2 DM Exclusion Criteria: 1. Recipient of an organ transplant other than a simultaneous pancreas kidney transplant 2. Known to be pregnant 3. Known to be infected with Human Immunodeficiency Virus with actively replicating HIV virus 4. Active BK viremia with \>100,000 copies or biopsy proven BK nephropathy 5. Participation in other biomarker studies 6. Pancreas transplant alone 7. Re-transplantation, unless both organs have been removed prior to or at the time of the retransplant procedure.