Choi Ji Yoon, Jung Joo Hee, Shin Sung, Kim Young Hoon, Han Duck Jong
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
PLoS One. 2017 Nov 2;12(11):e0186827. doi: 10.1371/journal.pone.0186827. eCollection 2017.
Pancreas transplantation is considered a therapeutic option for patients with complicated diabetes mellitus. In this study, we compared survival rate between patients on the waiting list for pancreas transplant alone(PTA), simultaneous pancreas-kidney(SPK) transplant, and pancreas after kidney(PAK) transplant and transplant recipients. A total of 503 patients (PTA:n = 116; SPK:n = 303; PAK:n = 84) and 280 PT recipients (PTA:n = 89; SPK:n = 155; PAK:n = 36) were retrospectively analyzed at our center between February 2000 and December 2015; 11.9%(60/503) of the patients on the waiting list and 4.3%(12/280) of the PT recipients died. The overall survival rate was higher in the waiting list group for the first year (99.3% vs. 97.8%), after which it was significantly higher in PT group (p = 0.039). The overall relative risk of all-cause mortality for transplant recipients was 2.145(p = 0.285) for PTA, 0.688(p = 0.735) for PAK, however,0.361 (p = 0.012) for SPK compared with that for the waiting list patients. SPK transplant recipients had considerable higher survival benefits, despite the relatively long waiting period, especially after 1 year. In addition, PTA and PAK can also be considered as a treatment option as patient survival was not poor.
胰腺移植被认为是患有复杂糖尿病患者的一种治疗选择。在本研究中，我们比较了单纯胰腺移植（PTA）、胰肾联合移植（SPK）和肾后胰腺移植（PAK）等待名单上的患者与移植受者之间的生存率。2000年2月至2015年12月期间，我们中心对总共503例患者（PTA：n = 116；SPK：n = 303；PAK：n = 84）和280例胰腺移植受者（PTA：n = 89；SPK：n = 155；PAK：n = 36）进行了回顾性分析；等待名单上11.9%（60/503）的患者和4.3%（12/280）的胰腺移植受者死亡。等待名单组第一年的总生存率较高（99.3%对97.8%），此后胰腺移植组的总生存率显著更高（p = 0.039）。与等待名单上的患者相比，胰腺移植受者全因死亡率的总体相对风险，PTA为2.145（p = 0.285），PAK为0.688（p = 0.735），而SPK为0.361（p = 0.012）。尽管等待时间相对较长，但SPK移植受者有相当高的生存获益，尤其是在1年后。此外，由于患者生存率不差，PTA和PAK也可被视为一种治疗选择。
