 Pancreas transplants have been performed in Japan since 2000 with a total of 437 procedures completed as of 2019. Of these, 410 were from deceased donors and 27 were from living donors. The majority of deceased donors used expanded donor criteria, which is higher than in other countries. At five years post-transplant, the overall survival rate was 95.8 percent, while the graft survival rate was 85.9 percent. This compares favorably to other countries, but there is still room for improvement due to the lower survival rate in pancreas after kidney transplant patients, 76.2 percent. Additionally, pancreas transplant patients who underwent pancreas after kidney transplant had a higher rate of graft failure than those who received simultaneous pancreas kidney transplants. This suggests that further research into immunologically-based causes of graft failure should be conducted. This article was authored by Yoshido Tamamaru, Hidate Hoshiguchi, Uichiro Doki, and others.