Buggenhout Alexis, Hoang Anh Dung, Hut Florence, Lekeufack Jean B, Bali Maria-Antoniela, De Pauw Luc
Clinique de Néphrologie Chirurgicale, Hôpital Erasme, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium.
Am J Transplant. 2004 Apr;4(4):663-5. doi: 10.1111/j.1600-6143.2004.00371.x.
The lower age limit for pancreas donors is not well defined. Fear of inadequate islet beta-cell mass and of technical complications has hampered the use of pediatric donors. A surgical technique of 'en bloc' kidney-pancreas is described. Both kidneys and pancreas were removed en bloc from a 13-kg, 31-month-old child. During bench preparation, one anastomosis was performed between the portal vein and the inferior vena cava. The proximal end of the aorta was closed. The bloc was transplanted into a 36-year-old type I diabetic patient intraperitoneally in the right iliac fossa. The kidneys functioned immediately. Pancreatic graft function resumed after POD 15 but insulin therapy was maintained until POD 112. Currently, the patient retains excellent kidney and pancreas graft functions. Very young donors can be accepted as pancreas donors for adult recipients, although slow recovery of pancreatic function can be expected. Use of the en bloc technique is well suited for very small children, as it prevents potential vascular complications.
胰腺供体的年龄下限尚无明确界定。对胰岛β细胞数量不足以及技术并发症的担忧阻碍了儿科供体的使用。本文描述了一种“整块”肾 - 胰腺的手术技术。从一名体重13千克、31个月大的儿童身上整块切除了双肾和胰腺。在实验台准备过程中，在门静脉和下腔静脉之间进行了一次吻合。主动脉近端被封闭。该组织块被移植到一名36岁的I型糖尿病患者的右髂窝腹膜内。肾脏立即发挥功能。胰腺移植功能在术后第15天恢复，但胰岛素治疗一直维持到术后第112天。目前，该患者的肾脏和胰腺移植功能良好。尽管预期胰腺功能恢复缓慢，但非常年幼的供体可被接受作为成年受者的胰腺供体。整块技术的应用非常适合非常年幼的儿童，因为它可预防潜在的血管并发症。
