Pancreas transplantation is currently performed since 1980 all over the world. Around 1500 transplantations are performed per year in the US and 1500 out US. Main indication is type 1 diabetes mellitus. Transplantation can be done simultaneously with a kidney, after a kidney transplant or alone in the absence or kidney transplantation. Data from the US transplant program are mostly send to the International Pancreas Transplant Registry in Minneaopolis. Non-US transplants are not systematically recorded and no local nor European network is currently available to summarize this transplant activity.

Pancreas DIVAT is an international network which include today three university hospital transplant centres: Nantes, Lyon and Pisa. In the near future, a new centre from Italy (Padova) will also take part of the network. All actual transplant centres involved in this pancreas network are major and experienced centres in the field of pancreas transplantation. Lyon (Hôpital Edouard Herriot) in one of the oldest centres in the world performing pancreas transplantation; the first pancreas transplant was performed in 1976 by Jean-Michel Dubernard and Jules Traeger. Up today, Lyon performed almost 700 pancreas transplantations and currently is one of the French leader centres with almost 30 to 35 pancreas transplant per year.

The University Hospital of Nantes started the clinical pancreas transplant program in 1986. Since this time, 400 transplants were performed and every year between 30 to 35 transplants are done.  Nantes and Lyon represent 90% of all pancreas transplantations performed in France every year.

The University of Pisa started performing pancreas transplantation in 1996. More than 250 transplants were done, including one of the largest experience with single pancreas transplantation in the world. Pisa, Padova and Milano are the main pancreas centres in Italy.

Creating a new source of data available in France and Italy may contribute to establish a new data-base with more than 1200 pancreas transplants already performed and around 100 new transplants per year. This tool may encourage more European transplant centres to join the Pancreas DIVAT network and increase the number of cases significantly.

Main objectives of the Pancreas DIVAT network are:

• Allow clinical studies with large number of cases with sufficient power to allow statistical analyses
• Investigate clinical risk parameters of pancreas graft failure (mainly secondary to technical failures)
• Investigate prospectively the role of anti-donor HLA antibodies on pancreas graft function and survival
• Promote randomized studies to test new surgical techniques and new immunosuppressants
• Promote the indication of pancreas transplantation alone among diabetics with nephropathy and preserved renal function
• Promote medical transplant physician exchanges between centres

Clinical research assistants are required to incorporate data and to validate them. One medical coordinator per centre is necessary and a principal coordinator (currently Diego Cantarovich) will manage all type of queries.