In the last several years, pancreas transplantation has developed into a highly successful surgical modality of treating selected patients for type I diabetes. The bladder technique is a simple, safe, and reliable technical surgical procedure that is now available. Long-term follow-up studies are demonstrating the beneficial effects of pancreatic grafts on secondary complications. New advances in molecular genetics may one day allow the transplantation of islets or genetically engineered cells, thus supplanting the need for transplantation of the whole pancreas. © 1992.