Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Surg Today. 2013 Dec;43(12):1406-11. doi: 10.1007/s00595-013-0516-6. Epub 2013 Feb 20.
We herein report our experience with pancreas transplantation in 26 patients at a single institution in Japan between August 2001 and December 2011.
We reviewed the medical records of 26 pancreas transplantations performed in our institute.
The early complications (within 2 weeks) included one graft venous thrombosis, one arterial thrombosis, and two reoperations for bleeding. Of the 26 pancreas transplant recipients, five lost pancreas graft function. Of 24 simultaneous pancreas-kidney recipients, three lost kidney graft function due to noncompliance. The patient, pancreas, and kidney survival rates were 100, 96 and 93 % at 1 year; 100, 80 and 93 % at 5 years; and 100, 67 and 68 % at 10 years, respectively. Of all these complications, venous thrombosis after pancreas transplantation was the most critical.
As the largest series of pancreas transplantations in a single institution in Japan, our series yielded better results than the worldwide data recorded by the International Pancreas Transplant Registry. Routine postoperative anticoagulation therapy is not necessary for the prevention of graft thrombosis if sufficient fluid infusion is strictly controlled and the graft blood flow is frequently monitored. When graft thrombosis occurs, both early detection and appropriate intervention are extremely important if the pancreas graft is to survive.
我们在此报告了 2001 年 8 月至 2011 年 12 月期间，在日本的一家单机构中进行的 26 例胰腺移植的经验。
我们回顾了我院进行的 26 例胰腺移植患者的病历。
早期并发症（2 周内）包括 1 例移植物静脉血栓形成、1 例动脉血栓形成和 2 例因出血而再次手术。26 例胰腺移植受者中，5 例胰腺移植物功能丧失。24 例同时进行的胰肾移植受者中，由于不遵医嘱，有 3 例肾脏移植物功能丧失。1 年时，患者、胰腺和肾脏的存活率分别为 100%、96%和 93%；5 年时分别为 100%、80%和 93%；10 年时分别为 100%、67%和 68%。在所有这些并发症中，胰腺移植后静脉血栓形成是最关键的。
作为日本单机构中最大的胰腺移植系列，我们的系列结果优于国际胰腺移植登记处记录的全球数据。如果严格控制补液和频繁监测移植物血流，预防移植物血栓形成并不需要常规术后抗凝治疗。如果要使胰腺移植物存活，发生移植物血栓形成时，早期发现和适当干预非常重要。
