du Toit D F, Heydenrych J J
S Afr Med J. 1986 Dec 20;70(13):822-6.
Until June 1983 a total of 280 human pancreatic transplantations had been performed world-wide. Until July 1983, 57 were functioning (22%), 11% for more than 12 months. During the past 5 years a steady increase in the number of segmental transplants has been observed. In most cases simultaneous transplantation of pancreas and kidney was performed (144 cases), in 65 cases the pancreas was transplanted metachronously after kidney grafting, and in 64 cases pancreatic transplantation was performed alone. Currently, segmental or whole pancreatic transplantation is the favoured procedure. Islet transplantation has been disappointing because of the difficulty in procuring sufficient numbers of islets from an adult pancreas followed by immunological destruction of the transplanted islets. Most pancreas grafts have been procured from cadavers, but the favoured segmental technique allows living related donors to be used. After rejection the graft does not always have to be removed and exogenous insulin administration may be resumed, either permanently or until re-transplantation can be accomplished. Life-long immunosuppression is needed after transplantation and currently pancreatic allograft survival rates for cyclosporin (CSA) and azathioprine-treated patients have been similar. The longest survival of a living diabetic recipient with a functioning pancreas is 5 1/2 years. Some authors have recently claimed improvement and stabilization of impaired nerve conduction and diabetic retinopathy after pancreatic transplantation.
到1983年6月，全世界共进行了280例人类胰腺移植手术。到1983年7月，有57例移植胰腺仍在发挥功能（占22%），其中11%的功能维持超过12个月。在过去5年中，节段性胰腺移植的数量呈稳步上升趋势。在大多数情况下，胰腺和肾脏同时进行移植（144例），65例在肾移植后分期进行胰腺移植，64例单独进行胰腺移植。目前，节段性或全胰腺移植是首选的手术方式。胰岛移植一直不尽人意，原因是从成人胰腺获取足够数量的胰岛存在困难，且移植后的胰岛会遭受免疫破坏。大多数胰腺移植物取自尸体，但受青睐的节段性移植技术允许使用活体亲属供体。移植胰腺发生排斥反应后，不一定总是要将其切除，可恢复外源性胰岛素注射，要么是永久性的，要么直到能够再次进行移植。移植后需要终身免疫抑制治疗，目前接受环孢素（CSA）和硫唑嘌呤治疗的患者的胰腺同种异体移植存活率相似。有功能的胰腺移植给糖尿病患者后，存活时间最长的为5年半。最近一些作者声称，胰腺移植后神经传导受损和糖尿病视网膜病变有所改善并趋于稳定。
