从心跳死亡供者获取的胰腺移植：非理性的排斥？
Pancreas Transplantation from Donors after Circulatory Death: an Irrational Reluctance?
机构信息
Department of Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
出版信息
Curr Diab Rep. 2019 Nov 18;19(11):129. doi: 10.1007/s11892-019-1238-y.
PURPOSE OF REVIEW
Beta-cell replacement is the best therapeutic option for patients with type 1 diabetes. Because of donor scarcity, more extended criteria donors are used for transplantation. Donation after circulatory death donors (DCD) are not commonly used for pancreas transplantation, because of the supposed higher risk of complications. This review gives an overview on the pathophysiology, risk factors, and outcome in DCD transplantation and discusses different preservation methods.
RECENT FINDINGS
Studies on outcomes of DCD pancreata show similar results compared with those of donation after brain death (DBD), when accumulation of other risk factors is avoided. Hypothermic machine perfusion is shown to be a safe method to improve graft viability in experimental settings. DCD should not be the sole reason to decline a pancreas for transplantation. Adequate donor selection and improved preservation techniques can lead to enhanced pancreas utilization and outcome.
目的综述
β细胞替代是 1 型糖尿病患者的最佳治疗选择。由于供体稀缺，更多的扩展标准供体被用于移植。由于并发症风险较高，心脏死亡后捐献者（DCD）通常不用于胰腺移植。本综述概述了 DCD 移植的病理生理学、危险因素和结果，并讨论了不同的保存方法。
最近的发现
当避免其他危险因素的积累时，DCD 胰腺的研究结果与脑死亡后捐献（DBD）的结果相似。低温机器灌注被证明是一种安全的方法，可以在实验环境中提高移植物的活力。DCD 不应该是拒绝移植胰腺的唯一原因。适当的供体选择和改进的保存技术可以提高胰腺的利用率和结果。
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