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单纯胰体尾联合孤立脾动脉移植:单中心经验。

Pancreas transplantation with isolated splenic artery blood supply - Single center experience.

机构信息

N.V.Sclifosovsky Research Institute for Emergency Medicine, Kidney and Pancreas Transplantation Department, Moscow, Russia; Moscow State University of Medicine and Dentistry, Department of Transplantation and Artificial Organs, Moscow, Russia; Scientific Research Institute of Healthcare Organization and Medical Management, Moscow, Russia.

N.V.Sclifosovsky Research Institute for Emergency Medicine, Kidney and Pancreas Transplantation Department, Moscow, Russia.

出版信息

Asian J Surg. 2020 Jan;43(1):315-321. doi: 10.1016/j.asjsur.2019.06.011. Epub 2019 Jul 10.

Abstract

BACKGROUND

The blood supply of the native pancreas by three arterial lines from the celiac trunk system (splenic artery and common hepatic artery) and the superior mesenteric artery forces surgeons to perform vascular reconstruction to provide sufficient intra-organ blood flow into the graft. The purpose of our study was to assess the possibility of pancreas transplantation with an isolated splenic artery blood supply.

METHODS

From January 2012 to July 2018, simultaneous pancreas-kidney transplantation (SPKT) was performed in 21 patients. Gender: male - 11 (52,4%), female 10 (47,6%). Recipients aged 26 to 54, the median age was 38 [34; 42] years. In 6 (28,6%) recipients, the organ perfusion was carried out through the splenic artery alone; in the rest, it was performed through the splenic and inferior pancreaticoduodenal artery exiting from the superior mesenteric artery of the graft. The transplant function, the quality of carbohydrate metabolism compensation, the objective characteristics of intra-organ blood flow was assessed.

RESULTS

There were no statistically significant differences in the volume blood flow characteristics revealed by CT-perfusion and laboratory data in the study groups.

CONCLUSIONS

Based on the assessment of the function and quality of blood supply to the transplant, the possibility of performing pancreas transplantation with an isolated splenic artery blood supply had been proved.

摘要

背景

来自腹腔干系统(脾动脉和肝总动脉)和肠系膜上动脉的三条动脉线为原胰腺提供血液供应,这迫使外科医生进行血管重建,以提供足够的器官内血流进入移植物。我们研究的目的是评估单纯脾动脉血供进行胰腺移植的可能性。

方法

从 2012 年 1 月至 2018 年 7 月,对 21 例患者同时进行胰肾联合移植(SPKT)。性别:男性 11 例(52.4%),女性 10 例(47.6%)。受者年龄 26 至 54 岁,中位年龄 38[34;42]岁。在 6 例(28.6%)受者中,器官灌注仅通过脾动脉进行;在其余受者中,通过脾动脉和来自移植物肠系膜上动脉的胰下十二指肠动脉进行。评估移植功能、碳水化合物代谢补偿质量、器官内血流的客观特征。

结果

CT 灌注和实验室数据显示两组的血流特征无统计学差异。

结论

基于对移植功能和血液供应质量的评估,已经证明了单纯脾动脉血供进行胰腺移植的可能性。

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