Diabetes mellitus is a health concern of the first order, given the high level of
associated morbidity and mortality. The objective, in order to slow down the
advance of its complications before they become irreversible, is based on correct
metabolic control. The high rate of morbidity associated with the surgery of the
vascularized pancreas transplant and the high index of rejection have for three
decades formed an obstacle to this being considered a valid alternative in the
treatment of these patients. Nowadays the pancreas transplant has come to occupy
a key position, thanks to the new regimes of immunosuppression and to the
perfection of surgical techniques. In this article we review the evolution of the
pancreas transplant from its beginnings to its present state
