成功进行来自边缘供体的同期肾胰联合移植。

Successful simultaneous kidney-pancreas transplantation from extreme donors.

作者信息

Stratta R J, Sundberg A K, Farney A C, Rohr M S, Hartmann E L, Adams P L

机构信息

Dept. of General Surgery, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157-1095, USA.

出版信息

Transplant Proc. 2005 Oct;37(8):3535-7. doi: 10.1016/j.transproceed.2005.09.060.

DOI:10.1016/j.transproceed.2005.09.060

PMID:16298652

Abstract

UNLABELLED

The purpose of this study was to retrospectively review our experience with "extreme" pancreas donors compared to conventional (CONV) donors.

METHODS

"Extreme" (EX) pancreas donors were defined as deceased donors (DDs) age >50 years, <8 years, donation after cardiac death (DCD), and targeted for organ discard.

RESULTS

From January 2002 through January 2005, we performed 40 simultaneous kidney-pancreas transplants (SKPT) with Thymoglobulin induction, including 9 (22.5%) from EX and 31 from CONV DDs. Mean DD age was higher in EX DD (41.2 years EX vs 26.0 CONV, P < .05), but mean recipient age and cold ischemia times did not differ between groups. With a mean follow-up of 16.8 months in the EX DD group, patient and kidney graft survival rates are both 100%, and the pancreas graft survival rate is 89%. With a mean follow-up of 21.7 months in the CONV DD group, patient and kidney graft survival rates are both 93.5% and the pancreas graft survival rate is 77.4%. All patients with surviving grafts exhibited good initial (1 case of delayed kidney graft function in a CONV DD) and stable long-term kidney and pancreas graft function. Mean length of initial hospital stay and the incidences of acute rejection, readmissions, operative complications, and infections were similar between groups.

CONCLUSIONS

The results of this study suggest that the limits of donor acceptability continue to evolve as excellent outcomes can be achieved in SKPTs from selected EX DDs.

摘要

未标注

本研究的目的是回顾性分析我们在“极端”胰腺供体与传统（CONV）供体方面的经验。

方法

“极端”（EX）胰腺供体定义为年龄>50岁、<8岁的已故供体（DDs），心脏死亡后捐赠（DCD），且原本拟废弃其器官。

结果

从2002年1月至2005年1月，我们进行了40例采用胸腺球蛋白诱导的同期肾胰腺移植（SKPT），其中9例（22.5%）来自EX供体，31例来自CONV供体。EX供体的平均年龄更高（EX组为41.2岁，CONV组为26.0岁，P<.05），但两组间受者平均年龄和冷缺血时间无差异。EX供体组平均随访16.8个月，患者和肾移植存活率均为100%，胰腺移植存活率为89%。CONV供体组平均随访21.7个月，患者和肾移植存活率均为93.5%，胰腺移植存活率为77.4%。所有移植存活的患者均表现出良好的初始情况（CONV供体组有1例肾移植功能延迟）以及稳定的长期肾和胰腺移植功能。两组间初始住院时间的平均值、急性排斥反应发生率、再次入院率、手术并发症及感染发生率相似。