According to cases reported to the new international Human Pancreas and Islet Transplantation Registry, 190 pancreas transplants in 178 patients were performed worldwide between December 16, 1966, and December 31, 1981. Currently (March 1982), 19 patients have functioning pancreas grafts and are insulin-independent, 9 for more than 1 yr. All of the patients with currently functioning grafts were transplanted after 1977. Since 1970, 76 islet transplants have been attempted in 71 patients, of which almost all failed and no patients are currently insulin-independent. Although the technical problems with pancreas transplants are not entirely solved, the major cause of graft failure has been rejection. The need for antirejection therapy has limited the application of pancreas transplantation to diabetic renal eliografi recipients or to nonuremic patients whose complications of diabetes are, or predictably will be, worse than the side effects of chronic immunosup-pression. Pancreas transplantation can, however, be performed with expectation of long-term success in some patients with current surgical and immunosuppressive methods.

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