The organ-specific cut-off was once established to provide donor pancreases for islet transplantation. Although 173 pancreases were allocated and retrieved for islet transplantation only 17 islet transplantations were performed in the whole ET area in 2008 (ET data). In Germany two islet transplantations were performed in 2009. Best results after islet transplantation are achieved with organs obtained from young obese donors. Concerning allocation, no conflict of interest exists between whole organ and islet transplantation, the single active German islet center will take part in the EXPAND study. Meanwhile, according to the suggestions by the EXPAND study group, extended donor pancreases are intended to be offered regionally as "rescue" allocation to the centers. The centers should then decide if this organ can be transplanted as whole organ or if it can be used for islets.