Park J B, Kim Y H, Song K B, Chung Y S, Jang H J, Park J-Y, Kim S-C, Han D J
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Transplant Proc. 2012 May;44(4):925-8. doi: 10.1016/j.transproceed.2012.03.035.
Recently improved patient and graft survivals, as well as decreased of postoperative morbidity have ushered in pancreas transplantation (PT) due to technical refinements as well as better immunosuppression and postoperative management. Herein we analyzed the outcomes of PT over a 19-year experiences at a single center.
All recipients who underwent deceased donor or living donor PT from July 1992 to July 2011 were enrolled in this study. We reviewed their medical records, including operative records, as well as clinical and laboratory findings. We analyzed graft and patient survival rates using the Kaplan-Meier method.
One hundred fifty-three cases were performed between July 1992 and July 2011. The indication for PT was type I diabetes in 125 (81.7%), and type II diabetes in 28 (18.3%) patients. The pancreas donor was deceased in 139 (90.8%) and living in 14 cases (9.2%). The type of PT was simultaneous pancreas-kidney transplantation (n = 91, 59.5%), pancreas alone (n = 49; 32.0%), or pancreas after kidney (n = 13, 8.5%). Median follow-up was 43.0 months (range 0-228). At 1, 5, and 10 years overall patient survivals were 93.8%, 88.1%, and 85.1%, and graft survivals, 82.3%, 70.6%, and 64.6%, respectively. When we divided the deceased donor PT recipients into two groups according to when they underwent PT (up to 2005 [n = 54]) vs 2006 and later [n = 85]), the recent group showed significantly improved patient and graft survival rates (P < .001). With no difference between type I (n = 65) and type II (n = 20) patients (P = .159).
Considering the improved quality of life and long-term patient survival, PT can be an effective treatment strategy in diabetic patients requiring insulin regardless of type of disorder.
由于技术的改进以及更好的免疫抑制和术后管理，患者及移植物存活率近来有所提高，术后发病率有所降低，胰腺移植（PT）应运而生。在此，我们分析了单中心19年的胰腺移植结果。
本研究纳入了1992年7月至2011年7月期间接受尸体供体或活体供体胰腺移植的所有受者。我们查阅了他们的病历，包括手术记录以及临床和实验室检查结果。我们使用Kaplan-Meier方法分析移植物和患者存活率。
1992年7月至2011年7月期间共进行了153例手术。胰腺移植的适应证为1型糖尿病125例（81.7%），2型糖尿病28例（18.3%）。胰腺供体为尸体的139例（90.8%），活体的14例（9.2%）。胰腺移植类型为胰肾联合移植（n = 91，59.5%）、单纯胰腺移植（n = 49；32.0%）或肾后胰腺移植（n = 13，8.5%）。中位随访时间为43.0个月（范围0 - 228个月）。1年、5年和10年的总体患者存活率分别为93.8%、88.1%和85.1%，移植物存活率分别为82.3%、70.6%和64.6%。当我们根据尸体供体胰腺移植受者接受移植的时间（2005年及以前[n = 54]）与2006年及以后[n = 85]）将其分为两组时，近期组的患者和移植物存活率显著提高（P < .001）。1型（n = 65）和2型（n = 20）患者之间无差异（P = .159）。
考虑到生活质量的改善和患者的长期存活，胰腺移植对于需要胰岛素治疗的糖尿病患者，无论其糖尿病类型如何，都可以是一种有效的治疗策略。
