Pérez-Sáez María José, Pascual Julio
Department of Nephrology, Hospital del Mar, Barcelona 08003, Spain.
J Clin Med. 2015 Jun 9;4(6):1269-80. doi: 10.3390/jcm4061269.
Diabetes mellitus is one of the most important causes of chronic kidney disease (CKD). In patients with advanced diabetic kidney disease, kidney transplantation (KT) with or without a pancreas transplant is the treatment of choice. We aimed to review current data regarding kidney and pancreas transplant options in patients with both type 1 and 2 diabetes and the outcomes of different treatment modalities. In general, pancreas transplantation is associated with long-term survival advantages despite an increased short-term morbidity and mortality risk. This applies to simultaneous pancreas kidney transplantation or pancreas after KT compared to KT alone (either living donor or deceased). Other factors as living donor availability, comorbidities, and expected waiting time have to be considered whens electing one transplant modality, rather than a clear benefit in survival of one strategy vs. others. In selected type 2 diabetic patients, data support cautious utilization of simultaneous pancreas kidney transplantation when a living kidney donor is not an option. Pancreas and kidney transplantation seems to be the treatment of choice for most type 1 diabetic and selected type 2 diabetic patients.
糖尿病是慢性肾脏病（CKD）最重要的病因之一。在晚期糖尿病肾病患者中，进行或不进行胰腺移植的肾移植（KT）是首选治疗方法。我们旨在回顾关于1型和2型糖尿病患者肾和胰腺移植选择的当前数据以及不同治疗方式的结果。总体而言，尽管短期发病和死亡风险增加，但胰腺移植具有长期生存优势。这适用于胰肾联合移植或肾移植后胰腺移植，与单独肾移植（活体供体或尸体供体）相比。选择一种移植方式时，必须考虑其他因素，如活体供体的可用性、合并症和预期等待时间，而不是一种策略相对于其他策略在生存方面有明显优势。在选定的2型糖尿病患者中，当无法选择活体肾供体时，数据支持谨慎使用胰肾联合移植。胰腺和肾脏移植似乎是大多数1型糖尿病和选定的2型糖尿病患者的首选治疗方法。
