For important ethical and practical reasons, present human trials of islet transplantation in diabetes are restricted to subjects already committed to immunosup-pression by the need for kidney transplantation. Following the morphology of the transplanted kidney for possible reversal of diabetes-related changes may be the most valuable technique for demonstrating benefit from the restoration of islet function. Amelioration of diabetic vascular disease is the compelling reason for efforts to achieve effective islet transplantation.

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