Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gut Liver. 2010 Dec;4(4):450-65. doi: 10.5009/gnl.2010.4.4.450. Epub 2010 Dec 17.
Diabetes mellitus is generally treated with oral diabetic drugs and/or insulin. However, the morbidity and mortality associated with this condition increases over time, even in patients receiving intensive insulin treatment, and this is largely attributable to diabetic complications or the insulin therapy itself. Pancreas transplantation in humans was first conducted in 1966, since when there has been much debate regarding the legitimacy of this procedure. Technical refinements and the development of better immunosuppressants and better postoperative care have brought about marked improvements in patient and graft survival and a reduction in postoperative morbidity. Consequently, pancreas transplantation has become the curative treatment modality for diabetes, particularly for type I diabetes. An overview of pancreas transplantation is provided herein, covering the history of pancreas transplantation, indications for transplantation, cadaveric and living donors, surgical techniques, immunosuppressants, and outcome following pancreas transplantation. The impact of successful pancreas transplantation on the complications of diabetes will also be reviewed briefly.
糖尿病通常采用口服降糖药物和/或胰岛素治疗。然而，随着时间的推移，即使是接受强化胰岛素治疗的患者，与该疾病相关的发病率和死亡率也会增加，这在很大程度上归因于糖尿病并发症或胰岛素治疗本身。1966 年，人类首次进行了胰腺移植，此后，关于该手术的合法性一直存在争议。技术改进以及更好的免疫抑制剂和更好的术后护理的发展，使患者和移植物的存活率显著提高，术后发病率降低。因此，胰腺移植已成为糖尿病的治疗方法，尤其是 1 型糖尿病。本文概述了胰腺移植，涵盖了胰腺移植的历史、移植适应证、尸体供者和活体供者、手术技术、免疫抑制剂以及胰腺移植后的结果。还将简要回顾成功的胰腺移植对糖尿病并发症的影响。
