Intraportal or Intramuscular Site for Islets in Simultaneous Islet and Kidney Transplantation

Inclusion Criteria: * Male and female patients age 18 to 65 years of age. * Ability to provide written informed consent. * Mentally stable and able to comply with the procedures of the study protocol. * Clinical history compatible with type 1 diabetes with onset of disease at \< 40 years of age and insulin-dependence for \> 5 years at the time of enrolment. * Absence of stimulated C-peptide \<0.1 nmol/L in response to a MMTT. * All subjects must have received adequate medical treatment of their diabetes under the guidance from an experienced diabetologist. * All subjects must have renal failure and be eligible for renal transplantation according to local criteria. Exclusion Criteria: * Patients with prior organ transplants * Patients that qualify for local simultaneous pancreas-kidney transplantation program and who prefer that option * Patients with body mass index BMI \> 28. * Insulin requirement \> 1 Unit/kg/day. If the patient is on peritoneal dialysis the same limit is set when the extra carbohydrates in the dialysis fluids have been accounted for. * Consistently abnormal liver function tests ( \> 1.5 x the upper limit of normal on two consecutive measurements \> 2 weeks apart) * Unstable diabetic retinopathy * Hypercoagulability disorder or coagulopathy or International normalized ratio (INR)\>1.5 * Any history of malignancy except for completely resected squamous or basal cell carcinoma of the skin * Patients with unstable cardiovascular status * Patients with active infections, unless treatment is not judged necessary by the investigators * Patients with serological evidence of infection with HIV, hepatitis B (patients with serology consistent with previous vaccination and a history of vaccination are acceptable) or hepatitis C.