Suzuki A, Kenmochi T, Maruyama M, Saigo K, Akutsu N, Iwashita C, Otsuki K, Miyazaki M
Clinical Research Center, Chiba-East National Hospital, National Hospital Organization, Chiba, Japan.
Transplant Proc. 2008 Oct;40(8):2565-7. doi: 10.1016/j.transproceed.2008.08.070.
We performed the first case of simultaneous pancreas and kidney transplantation from a living donor (LDSPK) in 2004. We examined the quality of life (QOL) of performed 6 recipients and 5 donors among 8 LDSPK from 2004 to 2007 at our institution using Short Form 36. All recipients achieved insulin and hemodialysis independence after LDSPK with positive serum C-peptide levels. Before LDSPK, all scores of the 8 specific domains of the recipients were low (28.2 +/- 10.6), indicating extremely poor QOL. Both the Physical and the Mental Component Summary Scores (PCS/MCS) quickly increased after LDSPK. PCS at 6, 12, and 24 months after LDSPK were significantly higher than the pretransplantation level. MCS were also significantly higher than the pretransplantation level. LDSPK showed prominent QOL improvement for the recipient. Complications were not observed in any donor. Although PCS decreased at 6 months after the operation, it recovered at 12 and at 24 months after the operation. MCS was maintained at more than 50 from 6 to 24 months after the operation. QOL was well preserved in the LDSPK donors despite the major surgery. In conclusion, LDSPK was confirmed to be a potent tool for treatment of type 1 diabetes mellitus patients with end-stage renal disease (ESRD) by complete normalization of glucose metabolism and renal function. In addition to these medical advantages, both their physical and mental QOL were improved by LDSPK.
2004年，我们实施了首例活体供者同时进行胰腺和肾脏移植（LDSPK）手术。我们使用简短健康调查问卷（Short Form 36）对2004年至2007年在我院接受8例LDSPK手术的6例受者和5例供者的生活质量（QOL）进行了调查。所有受者在接受LDSPK手术后均实现了胰岛素和血液透析独立，血清C肽水平呈阳性。在接受LDSPK手术前，受者8个特定领域的所有评分均较低（28.2±10.6），表明生活质量极差。接受LDSPK手术后，身体和心理综合评分（PCS/MCS）均迅速提高。LDSPK术后6个月、12个月和24个月的PCS均显著高于移植前水平。MCS也显著高于移植前水平。LDSPK显著改善了受者的生活质量。未在任何供者中观察到并发症。虽然术后6个月PCS有所下降，但在术后12个月和24个月恢复。术后6至24个月，MCS维持在50以上。尽管接受了大手术，但LDSPK供者的生活质量仍得到了良好的维持。总之，通过使糖代谢和肾功能完全恢复正常，LDSPK被证实是治疗终末期肾病（ESRD）1型糖尿病患者的有效手段。除了这些医学优势外，LDSPK还改善了受者的身体和心理生活质量。
