Squifflet J P, Gianello P, Pacetti G, Alexandre G P
Service de Transplantation Rénale et Pancréatique, Cliniques Universitaires St. Luc, Bruxelles, Belgique.
Acta Chir Belg. 1991 Mar-Apr;91(2):96-9.
Today, combined kidney and pancreas transplantation is the best treatment for patients with type I diabetes and pre-end or end-stage renal disease due to the diabetic nephropathy. Twenty-nine patients underwent that procedure at our Institution. Recent technical modifications--with the use of a whole pancreas graft with urinary drainage of the exocrine secretion in the recipient by performing a pancreatico-duodeno-cystostomy--allow the monitoring of the exocrine secretion which is a pertinent immunological marker for pancreas rejection. In the next future, pancreas alone should be considered safely using the same procedure, in non uremic diabetic recipients in whom extra-renal secondary complications are more serious than the potential side effects of chronic immunosuppression. That type of pancreas transplantation should benefit of the forthcoming immunosuppressive drugs.
如今，肾胰联合移植是治疗I型糖尿病且因糖尿病肾病处于肾衰期前期或终末期的患者的最佳疗法。我院有29名患者接受了该手术。近期的技术改进——通过实施胰十二指肠膀胱吻合术，使用带有外分泌液尿路引流的全胰移植物——使得对外分泌液的监测成为可能，而外分泌液是胰腺排斥反应的一个相关免疫标志物。在不久的将来，对于非尿毒症糖尿病受者，若其肾外继发并发症比慢性免疫抑制的潜在副作用更严重，可考虑采用相同手术安全地进行单纯胰腺移植。这类胰腺移植应会受益于即将问世的免疫抑制药物。
