Sanchez Edmund Q, Melton Larry B, Chinnakotla Srinath, Levy Marlon F, Fischbach Bernard V, Goldstein Robert, Klintmalm Göran B
Baylor Regional Transplant Institute (Sanchez, Chinnakotla, Levy, Goldstein, Klintmalm), Dallas and Fort Worth, Texas; the Division of Nephrology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas (Melton); and the Division of Nephrology, Department of Internal Medicine, Baylor All Saints Medical Center, Fort Worth, Texas (Fischbach).
Proc (Bayl Univ Med Cent). 2010 Jan;23(1):3-6. doi: 10.1080/08998280.2010.11928569.
The success of pancreas transplantation has improved over the past several decades with advancements in surgical technique, immunosuppressive medicines, and immunologic testing. We retrospectively reviewed our experience with pancreas transplantation from 1995 to 2008. At the Baylor Regional Transplant Program, 151 pancreas transplants were performed in 147 patients: 135 were simultaneous pancreas-kidney transplants, 10 were pancreas transplants after kidney transplants, and 6 were pancreas transplants alone. Follow-up information was available for 138 patients. The 1-year acute cellular rejection rate was 31.6%; the 30-day surgical reexploration rate was 10%; and the technical failure rate was 5.3%. Five-year pancreas graft survival rates were 67% for simultaneous pancreas and kidney transplants and 50% for pancreas transplants after kidney transplants. These outcomes exceed expected results as calculated by the Scientific Registry of Transplant Recipients. In addition, the median time to transplant was 3.8 months, compared with a US median of 14.1 months. Pancreas transplantation is currently the closest thing to a cure for diabetes and should be given as an option for diabetic patients with or without end-stage renal disease.
在过去几十年中，随着手术技术、免疫抑制药物和免疫检测的进步，胰腺移植的成功率有所提高。我们回顾性分析了1995年至2008年期间我们胰腺移植的经验。在贝勒地区移植项目中，对147例患者进行了151例胰腺移植：135例为胰肾联合移植，10例为肾移植后胰腺移植，6例为单纯胰腺移植。有138例患者的随访信息。1年急性细胞排斥率为31.6%；30天手术再次探查率为10%；技术失败率为5.3%。胰肾联合移植的5年胰腺移植物存活率为67%，肾移植后胰腺移植的5年存活率为50%。这些结果超过了移植受者科学登记处计算的预期结果。此外，移植的中位时间为3.8个月，而美国的中位时间为14.1个月。目前，胰腺移植是最接近治愈糖尿病的方法，对于有或没有终末期肾病的糖尿病患者都应作为一种选择。
