Tydén G, Tollemar J, Bolinder J
Department of Transplantation Surgery, Karolinska Institute, Huddinge Hospital, Stockholm, Sweden.
Clin Transplant. 2000 Oct;14(5):505-8. doi: 10.1034/j.1399-0012.2000.140510.x.
The purpose of this study was to find out whether prolonged normoglycemia, as achieved by a successful pancreas transplantation, can improve survival in patients with insulin-dependent diabetes mellitus. A retrospective analysis of actual 10-yr patient survival rates was done for all renal graft recipients who were given transplants more than 10 yr ago but within the cyclosporin era (i.e. 1981-1988). The actual 10-yr patient survival rate in non-diabetic renal graft recipients was 72%, In recipients of pancreas and kidney grafts and with prolonged function of the pancreas graft, the survival rate was 60%, whereas in patients subjected to simultaneous pancreas and kidney transplantation, but where the pancreatic grafts failed within 2 yr, the survival rate was 33%. In diabetic recipients of kidney transplants alone, the survival rate was 37%. The patient survival rate was substantially higher in non-diabetic patients and patients with functioning pancreas grafts compared with diabetic patients with kidney transplants alone or with failed pancreas grafts. We speculate that the decrease in mortality was due to the beneficial effect of long-term normoglycemia on diabetic late complications.
本研究的目的是探究通过成功的胰腺移植所实现的长期血糖正常，是否能够提高胰岛素依赖型糖尿病患者的生存率。对所有在10多年前但在环孢素时代（即1981 - 1988年）接受移植的肾移植受者的实际10年患者生存率进行了回顾性分析。非糖尿病肾移植受者的实际10年患者生存率为72%，胰腺和肾移植受者且胰腺移植功能长期良好的患者，生存率为60%，而在同时接受胰腺和肾移植但胰腺移植在2年内失败的患者中，生存率为33%。仅接受肾移植的糖尿病受者，生存率为37%。与仅接受肾移植或胰腺移植失败的糖尿病患者相比，非糖尿病患者和胰腺移植功能良好的患者的患者生存率显著更高。我们推测死亡率的降低是由于长期血糖正常对糖尿病晚期并发症的有益作用。
