Simultaneous Islet-Kidney Transplantation in Patients of Type 1 Diabetes With End-stage Renal Disease

Inclusion Criteria: * Male and female patients age 18 to 60 years of age. * Ability to provide written informed consent. * Clinical history compatible with type 1 diabetes (T1DM) as defined by the WHO guidelines(1999) on the Diagnosis and classification of Diabetes Mellitus. * manifest signs and symptoms that are severe enough to be incapacitating. * Basal C-peptide\<0.5ng/mL * patients with poor diabetes control (HbA1c \>7% but \<12%) * progressive diabetic complications. * end-stage renal disease(serum creatinine\>450μmol/l) Exclusion Criteria: * age \<18 years or \>60 years * diabetic history \<5 years * BMI\>27 * body weight \>80kg * exogenous insulin requirement \>1 unit/kg/day * severe anemia (male \<8g/dl, female \<7g/dl) * low white blood cell count (\<3000/dl) * liver dysfunction * Symptomatic peptic ulcer disease * Any malignancy * Active infection including hepatitis B, hepatitis C, HIV, or TB * panel reactive antibody \>20% * Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial.