University of Arizona, Tucson, AZ.
SUNY Upstate Medical University, Syracuse, NY.
Am J Transplant. 2016 Feb;16(2):688-93. doi: 10.1111/ajt.13468. Epub 2015 Oct 5.
Pancreas after islet (PAI) transplantation is a treatment option for patients seeking insulin independence through a whole-organ transplant after a failed cellular transplant. This report from the International Pancreas Transplant Registry (IPTR) and the United Network for Organ Sharing (UNOS) studied PAI transplant outcomes over a 10-year time period. Forty recipients of a failed alloislet transplant subsequently underwent pancreas transplant alone (50%), pancreas after previous kidney transplant (22.5%), or simultaneous pancreas and kidney (SPK) transplant (27.5%). Graft and patient survival rates were not statistically significantly different compared with matched primary pancreas transplants. Regardless of the recipient category, overall 1- and 5-year PAI patient survival rates for all 40 cases were 97% and 83%, respectively; graft survival rates were 84% and 65%, respectively. A failed previous islet transplant had no negative impact on kidney graft survival in the SPK category: It was the same as for primary SPK transplants. According to this IPTR/UNOS analysis, a PAI transplant is a safe procedure with low recipient mortality, high graft-function rates in both the short and long term and excellent kidney graft outcomes. Patients with a failed islet transplant should know about this alternative in their quest for insulin independence through transplantation.
胰岛（islet）移植后胰腺（PAI）移植是一种治疗选择，适用于在细胞移植失败后通过全器官移植寻求胰岛素独立性的患者。国际胰腺移植登记处（IPTR）和器官共享联合网络（UNOS）的这份报告研究了 10 年期间 PAI 移植的结果。40 名胰岛同种异体移植失败的患者随后单独接受胰腺移植（50%）、先前肾移植后的胰腺移植（22.5%）或同时胰腺和肾移植（SPK）（27.5%）。与匹配的原发性胰腺移植相比，移植物和患者存活率没有统计学上的显著差异。无论患者类别如何，所有 40 例患者的 1 年和 5 年 PAI 患者存活率分别为 97%和 83%；移植物存活率分别为 84%和 65%。先前胰岛移植失败对 SPK 类别的肾移植物存活率没有负面影响：与原发性 SPK 移植相同。根据这项 IPTR/UNOS 分析，PAI 移植是一种安全的手术，患者死亡率低，短期和长期的移植物功能率高，肾移植物的结果也很好。胰岛移植失败的患者应该了解这种替代方案，以寻求通过移植实现胰岛素独立性。
