Wondering about a pancreatic transplant

i have heard a lot of mixed information. some success stories which really lead me to believe that pancreatic transplant is the answer. and others who say that the complexity and risk is too unbearable. i am confused...what do you guys think? why dont more people get this surgery...is it money related or is it the risk or is it just the fear of additional problems. I am reading about it but would really love some opinions. Thanks!

The problem is twofold:

1) transplanting a whole pancreas is a very serious operation as the pancreas is fragile and loaded with blood vessels. Surgeons in training have learn 3 rules :
1) Eat when you can,
2) sleep when you can,
3)don't f*** with the pancreas.

2) The *real* reason : after a pancreas transplant, you will need to be on anti-rejection drugs for the rest of your life. Current anti-rejection drugs, while better than the past, have side effects on the body that can be worse than diabetes side effects.

Hence pancreas transplants aren't done to cure diabetes unless there are other reasons to do so. For example if a diabetic needs a kidney transplant due to kidney failure (they will die otherwise) the pancreas can be transplanted too as the person will be
on anti-rejection drugs anyway for the kidney transpant and having the pancreas transplant will cure the diabetes and help spare the new kidneys. I have also heard of it being done in the case of extreme hypo unawareness and inability to manage BG any other way. There are some folks on here who have had a transplant and can speak more directly.

THe other option, mostly experimental, is islet cell transplants. This avoids the complex surgery as they just inject the insulin making islet-cells, which then find a home in your liver or other place. You still need anti-rejection (immune suppression) drugs to prevent your body from destroying the cells just as they did your original beta cells. So you still have to deal with the side effects of the anti-rejection drugs.

http://en.wikipedia.org/wiki/Islet_cell_transplantation

Research is being done to isolate or encapsulate the islet cells behind a barrier so they can get nourishment from your body, sense glucose, and release insulin, but not be attacked by your immune system. That would avoid the anti-rejection drugs and also allow the use of animal islet cells (from pigs, for example). The problem is still not solved.