Pancreatic Islet Cell Transplantation After Kidney Transplantation - A Novel Approach to Immunosupression

Inclusion Criteria: 1. Patient has been fully informed and has signed an IRB approved informed consent form and is willing and able to follow study procedures for the full 24 months. 2. Type 1 diabetes mellitus of more than 5 years duration 3. Age between 18 and 65 4. Unstable diabetes mellitus control despite expert management by a diabetology care team for at least 6 months prior to consideration for transplantation as defined by the following: * During the past six months (or during the period of intensive diabetes care): Any episodes of hypoglycemic unawareness, as defined by the inability to recognize glucose levels below 50 mg/dL; or episodes of loss of cognitive function; or frequent episodes of symptomatic hypoglycemia; or admission to the hospital for hypo- or hyperglycemia; and * HbA1C\>6.5%. 5. Patient underwent kidney transplantation at least six months before enrollment, and has stable kidney allograft function, defined as creatinine levels of maximum 2 mg/dl, stable renal allograft function as assessed by the transplant nephrologist, and has a creatinine clearance of more than 40 ml/min. 6. Psychogenically able to comply, in the opinion of the investigator 7. Female patients of childbearing potential must have a negative urine or serum pregnancy test upon hospitalization or within 7 days prior to enrollment and have agreed to utilize effective birth control throughout the study as well as for 6 weeks following study completion Exclusion Criteria: * Patient has previously received or is receiving an organ or bone marrow transplant other than a first kidney transplant. 2\. Patient has a known hypersensitivity to Tacrolimus, Sirolimus, Alemtuzumab, or Mycophenolate (allow substitution of Myfortic for CellCept). 3\. Patient is pregnant or lactating (must provide effective contraception method). 4\. Patient has participated in a blinded trial or participated in a trial involving a non-marketed (investigational) drug within 3 months of enrollment. 5\. Patient has participated in a trial involving a marketed drug or an infusion device within 30 days of the start of the trial. 6\. Patient exhibits any one of the following clinical criteria: * Creatinine clearance or Glofil test \< 40 mL/min * Serum creatinine \> 2.0 mg/dL consistently, or more than 0.2 mg/dl increase in creatinine over the last five months * Body mass index \> 28 * Malignancy other than BCC and SCC * Radiographic evidence of pulmonary infection * Evidence of liver disease as evidenced by \>2X ULN for AST, ALT, Alk. Phos., or T. bili. * Active infections * Hypercoagulable states (history of recurrent venous thrombosis, defined thrombophilia) * Bleeding / coagulation disorders * Basal C-peptide \> 0.3 ng/mL * HbA1C \>12% * Insulin requirement \> 1 IU/kg/day * Seropositivity for HIV, HBV, HCV, HTLV-I * Abnormal Pap smear, active gynecological infection * Positive exercise or chemical cardiac tolerance test * Patients currently under treatment for a medical condition requiring chronic use of steroids at a dose of prednisone \>10 mg/day will be excluded. * Substance/alcohol abuse * Untreated proliferating diabetic retinopathy * PPD conversion or positive PPD without INH if suspicious TB by chest X-ray or symptoms * No primary care physician or primary care physician less than 6 months * Smoking in the last 6 months * Abnormal CBC / Hemoglobin \< 10 g/dL * Microalbuminuria \> 300 mg/24 hrs * Untreated hyperlipidemia - TC \> 200 mg/dL, TGC \> 200 mg/dL, LDL \> 130 mg/dL * Untreated hyponatremia, hypokalemia, hypercalcemia, hypocalcemia * Iodine contrast allergy * PSA \> 4 ng/mL * PRA \> 20% * Active peptic ulcer disease/gallstones/hemangioma * Abnormal mammogram. * Patient receives any of the prohibited medications