Islet transplantation has surpassed whole pancreas transplantation as a cure for diabetes mellitus since the success of the Edmonton group. It is a safer procedure and requires minimal surgical intervention, yet offers excellent results in terms of achieving insulin independence. It also offers a more physiological insulin profile than current insulin replacement therapy. The UK Islet Transplant Consortium, founded by Diabetes UK, is in the process of establishing a programme of clinical islet transplantation in the UK.The immunosuppression required to protect islet grafts remains a threat to the long‐term health of transplant recipients and research into the possibility of circumventing the need for immunosuppression continues. The main areas under investigation include immunoisolation of islet grafts, HLA class II mismatching between donor and recipient, destruction of immune‐reactive dendritic cells in culture, in vitro pre‐treatment of islets to reduce their immunogenicity and genetic modification of islets to produce localised immunosuppression and prevent the release of MHC molecules.Because of the shortage of donors, researchers are looking toward alternative sources of glucose‐responsive insulin‐secreting tissue. Xenotransplantation would offer an attractive solution if the risk of transferring animal endogenous retroviruses can be eliminated. The expansion of mature beta‐cells, beta‐cell progenitors in pancreatic ducts or embryonic stem cells into viable tissue for transplant is also being researched in the hope of finding a solution for the tissue shortage issue. Encouraging advances have been made in many of these areas, creating a sense of anticipation and excitement for the future. Copyright © 2003 John Wiley & Sons, Ltd.

and the UK. Visual Analog Scale (VAS) scores were obtained to validate TTO scores. TTO scores were converted into utility values. Results: The highest mean TTO utility scores (range 0.66-0.82) were observed for the anchor HS (minimal disease activity) across all countries. All flare HS were associated with a disutility compared with the anchor HS: mild flare HS (0.55-0.71), moderate flare HS (0.38-0.53), severe renal flare HS (0.33-0.45), severe Central Nervous System (CNS) flare HS (0.30-0.45) and severe generalised flare HS (0.19-0.33). Significant differences were reported between the anchor state and each flare state across all countries (p< 0.05). Mean VAS scores followed the same trend. The severe generalised flare HS received the lowest mean TTO utility score across all six countries suggesting that the perceived day-to-day impact of a severe generalised flare was greater than a severe CNS or severe renal flare. ConClusions: These results show that a decrease in utility, representing a detrimental impact on HRQoL, was observed with increasing severity of flare. These results could be applied in cost-utility analyses for interventions for SLE. QL2