Tydén G, Tibell A, Bolinder J, Ostman J, Groth C G
Department of Transplantation Surgery, Huddinge Hospital Karolinska Institute, Stockholm, Sweden.
Clin Transpl. 1990:189-95.
One-hundred twenty-eight pancreatic transplantations were performed between 1974 and 1990; 117 of which were with pancreatico-enterostomy. Combined renal and pancreatic transplantations were performed in 68 uremic patients and in 8 preuremic recipients. Single pancreatic transplantations were performed in 31 recipients and in 6 instances, the pancreatic transplantation was performed in a patient who already had a renal graft. In 4 consecutive series (n = 15, 20, 21, 11) of combined transplantations in uremic diabetic patients, the 1-year graft survival rate has excessively improved markedly (27%, 65%, 68%, and 73%). In 3 similar series of single pancreatic transplantations (n = 7, 13, 6) the results also improved, but still remained inferior (0%, 33%, and 33%). In 42 patients followed for more than 1 year after transplantation, the mean blood glucose tolerance test 4.2 +/- 0.5, HbA1c 5.1 +/- 0.8, 2-hour blood glucose level of the oral glucose tolerance test 6.9 +/- 2.1 and the K-value of the intravenous glucose tolerance test 1.2 +/- 0.6%. The results with pancreatic transplantation with pancreatico-enterostomy are now satisfactory. However, immunological graft losses still constitute a major problem in the non- or preuremic recipients.
1974年至1990年间共进行了128例胰腺移植；其中117例采用胰肠吻合术。68例尿毒症患者和8例尿毒症前期受者接受了肾胰联合移植。31例受者接受了单纯胰腺移植，其中6例是在已有肾移植的患者中进行胰腺移植。在4组连续的尿毒症糖尿病患者联合移植系列中（n分别为15、20、21、11），1年移植肾存活率显著提高（分别为27%、65%、68%和73%）。在3组类似的单纯胰腺移植系列中（n分别为7、13、6），结果也有所改善，但仍较差（分别为0%、33%和33%）。42例患者移植后随访超过1年，平均血糖耐量试验为4.2±0.5，糖化血红蛋白为5.1±0.8，口服葡萄糖耐量试验2小时血糖水平为6.9±2.1，静脉葡萄糖耐量试验K值为1.2±0.6%。胰肠吻合术式的胰腺移植结果目前令人满意。然而，免疫性移植肾丢失在非尿毒症或尿毒症前期受者中仍然是一个主要问题。
