Close N, Alejandro R, Hering B, Appel M
EMMES Corp, Rockville, MD, USA.
Transplant Proc. 2007 Jan-Feb;39(1):179-82. doi: 10.1016/j.transproceed.2006.10.014.
In September 2001, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) founded the Collaborative Islet Transplant Registry (CITR). Each year, CITR produces a complete set of analyses available to the public. In its second year, CITR represents the efforts of 19 North American islet transplant programs reporting information on 138 islet transplant recipients (1999-2004), 256 processed pancreata that led to infusion, and 266 infusion procedures. This analysis focuses on recipients of islet-alone procedures. Median age of the recipient is 41.6 years (range, 23.1-64.4 years), duration of diabetes is 29 years (range, 4-50 years), and over 66% are female. Median weight of the recipient is 65 kg (range, 47-97 kg) and median body mass index (BMI) is 23.1 kg/m(2) (range, 18.8-31.6). Examining outcomes at 6 months following the recipient's last infusion, 67.0% are insulin independent, and at 12 months this percentage decreases to 58.0%. There is a striking decrease in the occurrence of severe hypoglycemic events subsequent to the first infusion. Over 82% of all recipients experience one or more severe hypoglycemic events in the year prior to their first infusion. However, only two recipients (2%) experience one or more severe hypoglycemic events between 30 days and 12 months postinfusion, but both of these recipients were on insulin replacement therapy and one had experienced a complete islet graft failure. The information provided in this analysis and subsequent analyses of CITR provides current and comprehensive information on outcome measures in islet transplantation.
2001年9月,美国国立糖尿病、消化和肾脏疾病研究所(NIDDK)建立了协作胰岛移植登记处(CITR)。每年,CITR都会生成一整套可供公众使用的分析报告。在其成立的第二年,CITR展示了19个北美胰岛移植项目的成果,这些项目报告了138名胰岛移植受者(1999 - 2004年)、256个用于输注的处理过的胰腺以及266次输注手术的相关信息。本分析聚焦于仅接受胰岛移植手术的受者。受者的中位年龄为41.6岁(范围为23.1 - 64.4岁),糖尿病病程为29年(范围为4 - 50年),超过66%为女性。受者的中位体重为65千克(范围为47 - 97千克),中位体重指数(BMI)为23.1千克/平方米(范围为18.8 - 31.6)。在受者最后一次输注后的6个月检查结果时,67.0%的受者无需使用胰岛素,而在12个月时,这一比例降至58.0%。首次输注后严重低血糖事件的发生率显著下降。超过82%的所有受者在首次输注前一年经历过一次或多次严重低血糖事件。然而,在输注后30天至12个月期间,只有两名受者(2%)经历过一次或多次严重低血糖事件,但这两名受者均接受胰岛素替代治疗,且其中一名受者经历了完全的胰岛移植失败。本分析及CITR后续分析中提供的信息,为胰岛移植的结果指标提供了当前全面的信息。