Pancreas transplantation is performed to establish a normoglycemic state, insulin-independent, in a diabetic type I recipient. Abundant evidence supports the concept that lesions developing in the eyes, nerves, kidneys and other organ systems are secondary to disordered metabolism and that restoration of normoglycemia will favorably influence their evolution. The need to provide antirejection, therapy currently confines the application of pancreas transplantation to three main groups of recipients: 1. patients who need a kidney transplant to treat end-stage diabetic nephropathy, 2. patients who received a renal transplant and have progressive systemic diabetic disease, 3. diabetics who are severely handicapped in their day-to-day lives because of difficulty with metabolic control. A significant improvement in the results of pancreas transplant has progressively occurred worldwide and several controlled studies are beginning to provide evidence of the favorable effect on secondary complications. The quality of life of these patients is also improved by a functioning graft.