Sirolimus vs Mycophenolate With Tacrolimus in Simultaneous Pancreas and Kidney Transplantation

Inclusion Criteria: * Type 1 diabetes mellitus * End stage kidney failure * Negative CDC crossmatch * Female patients of childbearing age must have a negative pregnancy test * Patient must have signed the Patient Informed Consent Form. * Patient must receive a primary simultaneous pancreas/kidney (SPK) cadaver transplant, Exclusion Criteria: * Patient is pregnant or breastfeeding. * Patient is allergic or intolerant to Mycophenolate Mofetil, Sirolimus, ATG, Tacrolimus * Patient has malignancy or history of malignancy, with the exception of adequately treated localized squamous cell or basal cell carcinoma, without recurrence. * Patient has been included in another clinical trial protocol for any investigational drug within 4 weeks prior to randomization. * Patient has any form of substance abuse or psychiatric disorder or condition, which invalidate communication. * Severe cardiac failure or severe liver failure diagnosed at the time of transplantation