Sugitani A, Ishibashi M, Ito T, Nakajima K, Matsuno N, Kanazawa Y, Motoyama K, Yamamoto H, Inoue S, Ota M, Yoshida J-I, Tanaka M
Central Pancreas Transplantation Committee, Graduate College of Medical Sciences, Kyushu University, Fukuoka, Japan.
Transplant Proc. 2004 Mar;36(2 Suppl):356S-361S. doi: 10.1016/j.transproceed.2003.12.033.
The number of pancreas transplants reached 16,043 worldwide in October 2001, with 1800 performed in 2000. Since the introduction of cyclosporine (CyA) in 1979, a regimen consisting of CyA, azathioprine, and steroids has been shown to improve long-term survival of clinical transplants. In Japan, the first simultaneous pancreas-kidney transplantation was performed in 1984, using organs from a brain-dead donor. This procedure was followed by 14 pancreas transplantations from cardiac arrest donors. All cases utilized a CyA-based regimen with antilymphocyte globulin or OKT3 induction. Six of the 15 recipients required less insulin postoperatively. Under a new transplant law enforced in 1997, 10 pancreas/pancreas-kidney transplantations were performed in patients diagnosed with end-stage renal failure due to diabetes mellitus type 1. In 1 patient, the graft failed due to venous thrombosis, but the other 9 recipients achieved an increased quality of life without the need for insulin or for dialysis. Pancreas transplantation represents an effective treatment worldwide and in Japan, due to the availability of CyA or tacrolimus in combination with other agents such as antilymphocyte globulin, OKT3, or mycophenolate mofetil. This investigation presents the results of pancreas-kidney transplantation in Japan, in comparison with those worldwide, and describes a recent case in Japan.
2001年10月，全球胰腺移植数量达到16043例，2000年为1800例。自1979年引入环孢素（CyA）以来，由CyA、硫唑嘌呤和类固醇组成的治疗方案已被证明可提高临床移植的长期存活率。在日本，1984年首次进行了同时胰腺-肾脏移植，使用的是脑死亡供体的器官。随后进行了14例来自心脏骤停供体的胰腺移植。所有病例均采用基于CyA的治疗方案，并使用抗淋巴细胞球蛋白或OKT3进行诱导。15名受者中有6名术后所需胰岛素减少。在1997年实施的一项新的移植法下，对10例因1型糖尿病导致终末期肾衰竭的患者进行了胰腺/胰腺-肾脏移植。1例患者因静脉血栓形成移植失败，但其他9名受者生活质量提高，无需胰岛素或透析。由于可获得CyA或他克莫司，并与抗淋巴细胞球蛋白、OKT3或霉酚酸酯等其他药物联合使用，胰腺移植在全球和日本都是一种有效的治疗方法。本研究展示了日本胰腺-肾脏移植的结果，并与全球结果进行了比较，还描述了日本最近的一个病例。
