成功的胰肾联合移植（胰腺第四期-肾脏第三期和胰腺第三期-肾脏第二期）：一例报告
Successful Combined Pancreas Fourth-Kidney Third and Pancreas Third-Kidney Second Transplantation: A Case Report.
作者信息
Bösmüller Claudia, Maglione Manuel, Margreiter Christian, Dziodzio Tomasz, Biebl Matthias, Pratschke Johann, Öllinger Robert, Öfner Dietmar, Schneeberger Stefan
机构信息
Department of Transplant Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Department of General Surgery, Charité Virchow Hospital, Berlin, Germany.
出版信息
Transplant Direct. 2015 Jul 24;1(6):e22. doi: 10.1097/TXD.0000000000000532. eCollection 2015 Jul.
UNLABELLED
Extremely few reports have been published on experience with multiple combined pancreas-kidney re-transplantation including long-term results. We here analyze our experience with two patients following successful combined pancreas fourth-kidney third and pancreas third-kidney second transplantation.
METHODS
Patient and graft survival as well as graft function and major complications were recorded. Patient 1 (women, 47 years) underwent combined pancreas fourth-kidney third transplantation after previous removal of the first and second renal and the second pancreatic grafts. Patient 2 (men, 51 years) underwent combined pancreas third-kidney second transplantation after nephrectomy of the first renal graft. Immunosuppression consisted of induction with alemtuzumab and maintenance with tacrolimus, mycophenolate mofetil/mycophenolic acid and steroids.
RESULTS
After a follow-up of 44 and 49 months, respectively, both patients are doing well with stable graft function. Leukopenia, thrombocytopenia, bacterial sepsis, and chronic hepatitis C as major complications were controllable.
CONCLUSIONS
Multiple pancreas-retransplantations combined with simultaneous renal transplantation are feasible. Meticulous immunosuppression, careful monitoring, and excellent patient adherence are of crucial importance.
未标注
关于多次联合胰腺 - 肾脏再次移植的经验，包括长期结果的报道极少。我们在此分析了两例患者在成功进行胰腺第四次 - 肾脏第三次和胰腺第三次 - 肾脏第二次联合移植后的经验。
方法
记录患者和移植物的存活情况以及移植物功能和主要并发症。患者1（47岁女性）在先前切除第一和第二个肾脏移植物以及第二个胰腺移植物后接受了胰腺第四次 - 肾脏第三次联合移植。患者2（51岁男性）在切除第一个肾脏移植物后接受了胰腺第三次 - 肾脏第二次联合移植。免疫抑制包括用阿仑单抗诱导以及用他克莫司、霉酚酸酯/霉酚酸和类固醇维持。
结果
分别随访44个月和49个月后，两名患者情况良好，移植物功能稳定。白细胞减少、血小板减少、细菌性败血症和慢性丙型肝炎等主要并发症是可控的。
结论
多次胰腺再次移植联合同期肾脏移植是可行的。精心的免疫抑制、仔细的监测以及患者的良好依从性至关重要。
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