Pancreas transplantation (PT) has become increasingly effective for the treatment of human diabetes. Islet transplants have been successful only in the laboratory; clinical human islet transplantation needs to be improved with a search to reduce islet cells immunogenicity. Up to now, the only effective method of endocrine replacement therapy in diabetic patients is vascularized pancreas transplantation. Analysis of the International Human Pancreas Registry shows that the best options in 1985 are enteric diversion of the exocrine function, simultaneous kidney graft from the same donor and cyclosporin combined with other immunosuppressive agents in the recipient.