Sutherland D E, Moudry-Munns K C
Department of Surgery, University of Minnesota Hospital, Minneapolis.
Clin Transpl. 1988:53-64.
From December 1966 to December 1988, 1,830 pancreas transplants were reported to the International Pancreas Transplant Registry. Of these, 1,549 were reported as of June 30, 1988 and analyzed on July 13, 1988. One-year actuarial graft function (insulin-independent) and recipient survival rates for all cases were 42% and 80%, respectively. In an analysis by era of 1966 to 1977 (n = 64), 1978 to 1983 (n = 336), 1984 to 1985 (n = 387), and 1986 to 1988 (n = 762) cases, 1-year graft function rates were 5%, 25%, 41%, and 55% and recipient survival rates were 44%, 72%, 81%, and 88%, respectively (p less than or equal to 0.01 all comparisons). In an analysis of 1984 to 1988 cases only (n = 1,149), the overall 1-year graft function and patient survival rates were 49% and 85%, respectively. During this period, graft functional survival rates for the most common duct management methods were 53% for duct injection (n = 313), 45% for intestinal drainage (n = 257), and 51% for bladder drainage (n = 535) at 1 year (p less than 0.04 for intestinal vs bladder drainage). Graft function rates were similar for whole (n = 552) and segmental (n = 595) pancreas transplants (48% vs 50% at 1 year). Functional survival rates according to duration of preservation for grafts stored less than 6 hours (n = 706), 6-12 hours (n = 243), 12-24 hours (n = 95), and 12-24 hours (n = 9) were 50%, 47%, 43%, and 78% at 1 year, and none of the differences were significant. Graft functional survival rates for 1984 to 1988 cases were significantly higher (p less than 0.05) in recipients who received AZA and CsA in combination (n = 895) than in those who received CsA without AZA (n = 218) or AZA without CsA, (n = 27), with 1-year graft functional survival rates of 52%, 41%, and 33%, respectively. For technically successful grafts, the function survival rates were also significantly higher (p less than 0.05) in recipients treated with CsA + AZA (n = 708) than in those who received CsA without AZA (n = 156) or AZA without CsA (n = 19), with 1-year function rates of 66%, 56%, and 47%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
1966年12月至1988年12月期间，国际胰腺移植登记处共收到1830例胰腺移植报告。其中，截至1988年6月30日报告了1549例，并于1988年7月13日进行了分析。所有病例的1年精算移植功能（不依赖胰岛素）和受者生存率分别为42%和80%。在按时间段分析时，1966年至1977年（n = 64）、1978年至1983年（n = 336）、1984年至1985年（n = 387）以及1986年至1988年（n = 762）的病例中，1年移植功能率分别为5%、25%、41%和55%，受者生存率分别为44%、72%、81%和88%（所有比较p均≤0.01）。仅分析1984年至1988年的病例（n = 1149）时，总体1年移植功能和患者生存率分别为49%和85%。在此期间，1年时最常见的导管处理方法的移植功能生存率为：导管注射（n = 313）为53%，肠道引流（n = 257）为45%，膀胱引流（n = 535）为51%（肠道引流与膀胱引流比较p＜0.04）。全胰腺移植（n = 552）和节段性胰腺移植（n = 595）的移植功能率相似（1年时分别为48%对50%）。对于保存时间小于6小时（n = 706）、6 - 12小时（n = 243）、12 - 24小时（n = 95）以及24小时以上（n = 9）的移植物，1年时的功能生存率分别为50%、47%、43%和78%，差异均无统计学意义。1984年至1988年病例中，联合使用硫唑嘌呤（AZA）和环孢素（CsA）的受者（n = 895）的移植功能生存率显著高于单独使用CsA（n = 218）或单独使用AZA（n = 27）的受者，1年移植功能生存率分别为52%、41%和33%（p＜0.05）。对于技术成功的移植物，接受CsA + AZA治疗的受者（n = 708）的功能生存率也显著高于单独使用CsA（n = 156）或单独使用AZA（n = 19）的受者，1年功能率分别为66%、56%和47%（p＜0.05）。（摘要截断于400字）
