Melandri M, Dubernard J M, Sanseverino R, Camozzi L, LeFrancois N, Faure J L, Martin X, La Rocca E, Gelet A, Touraine J L
Unit of Transplantation, E. Herriot Hospital, Lyon, France.
Diabetes. 1989 Jan;38 Suppl 1:30-2. doi: 10.2337/diab.38.1.s30.
Since November 1975, 103 pancreas transplantations have been performed in 97 insulin-dependent diabetic patients. Pancreas and kidney were grafted simultaneously in 84 patients (plus 1 double retransplantation). Eighty-nine pancreas grafts were prepared by duct obstruction with neoprene, and 14 were pancreaticoduodenal grafts with enteric diversion in a Roux-en-Y loop. Five immunosuppressive protocols were subsequently used. With the latest protocols, patient and pancreas survival improved to 93 and 72% at 1 yr, respectively. The improvement in graft survival appeared to be particularly related to the reduction of the number of pancreas grafts lost in rejection. The patients treated with the last protocols, including cyclosporin A (CsA) and only low doses of steroids, showed a better glucose tolerance after provocative tests. Pancreas-graft function did not appear to be influenced by CsA treatment.
自1975年11月以来，已对97例胰岛素依赖型糖尿病患者实施了103例胰腺移植手术。84例患者同时进行了胰腺和肾脏移植（另加1例二次重复移植）。89例胰腺移植物通过氯丁橡胶导管阻塞制备，14例为胰十二指肠移植物，采用Roux-en-Y袢肠内转流术。随后使用了五种免疫抑制方案。采用最新方案后，患者和胰腺1年生存率分别提高到93%和72%。移植物生存率的提高似乎尤其与排斥反应中丢失的胰腺移植物数量减少有关。采用包括环孢素A（CsA）和低剂量类固醇的最新方案治疗的患者，在激发试验后显示出更好的糖耐量。胰腺移植物功能似乎不受CsA治疗的影响。
