Bigam David L., Shapiro AM James
University of Alberta Hospital, 8440-112 Street NW, Edmonton, Alberta, T6G 2B7, Canada.
Curr Treat Options Gastroenterol. 2004 Oct;7(5):329-341. doi: 10.1007/s11938-004-0046-9.
Diabetes is a leading cause of morbidity and mortality worldwide. Complications of diabetes including renal failure, retinopathy, neuropathy, and cardiovascular disease limit both survival and quality of life. Pancreatic transplantation can restore euglycemia thereby stabilizing or even reversing secondary complications of diabetes as well as improving quality of life particularly in patients with labile diabetes. Recent evidence also shows an improved survival in diabetic patients that undergo pancreatic transplantation when combined with a kidney transplant. Pancreatic transplantation should more properly be referred to as beta cell replacement as the field today encompasses both whole organ and islet cell transplantation. We have outlined herein the indications and contraindications to islet or whole organ pancreas transplantation and we have described periprocedure care and short- and long-term prognosis.
糖尿病是全球发病和死亡的主要原因。糖尿病并发症包括肾衰竭、视网膜病变、神经病变和心血管疾病，这些并发症限制了患者的生存期和生活质量。胰腺移植可以恢复血糖正常，从而稳定甚至逆转糖尿病的继发性并发症，并改善生活质量，尤其是对于脆性糖尿病患者。最近的证据还表明，糖尿病患者在接受胰腺移植并同时进行肾移植时，生存期会有所改善。胰腺移植更确切地应称为β细胞替代，因为目前该领域涵盖了全器官移植和胰岛细胞移植。我们在此概述了胰岛或全器官胰腺移植的适应证和禁忌证，并描述了围手术期护理以及短期和长期预后。
