胰腺移植对患者生存的影响——日本胰腺移植登记处分析
Impact of Pancreas Transplantation on the Patient Survival-An Analysis of the Japanese Pancreas Transplants Registry.
作者信息
Ito Taihei, Kenmochi Takashi, Aida Naohiro, Matsushima Hajime, Kurihara Kei, Ishihara Takuma, Shintani Ayumi, Asaoka Tadafumi, Ito Toshinori
机构信息
Department of Transplantation and Regenerative Medicine, School of Medicine, Fujita Health University, Dengakugakubo 1-98, Kutsukakecho, Toyoake-shi, Aichi 470-1192, Japan.
Gifu University Hospital, Innovative and Clinical Research Promotion Center, Gifu University, Gifu 501-1193, Japan.
出版信息
J Clin Med. 2020 Jul 6;9(7):2134. doi: 10.3390/jcm9072134.
BACKGROUND
The impact of pancreas transplantation, including kidney transplantation on patients' life prognoses, is unclear in Japan. An analysis of the data of the Japan Pancreas Transplant Registry was performed to compare the patient survival between on the waiting list and after pancreas transplantation, and investigate the factors that affect the patient survival after pancreatic transplantation.
METHODS
The life prognoses of 361 patients who underwent pancreas transplantation from 2000 to December 2018 were examined.
RESULTS
The survival rates at 1, 5, and 10 years on the waiting list were 98.4%, 90.3%, and 78.1%, respectively, while those after transplantation were significantly improved ( = 0.029) at 100%, 97.5%, and 88.9%, respectively. Furthermore, the survival rates of patients waiting for simultaneous pancreas and kidney transplantation (SPK) at 1, 5, and 10 years were 98.2%, 89.4%, and 75.4%, respectively, while those after SPK were also significantly improved ( = 0.026) at 100%, 94.6%, and 88.8%. The multivariable analysis revealed that the duration of diabetes before surgery was the only independent risk factor (hazard ratio = 1.095, = 0.012) that affected the patient survival after SPK.
CONCLUSION
Pancreas transplantation was found to improve the life prognosis of patients with type 1 diabetes, especially those with end-stage renal failure waiting for SPK.
背景
在日本，包括肾移植在内的胰腺移植对患者生命预后的影响尚不清楚。对日本胰腺移植登记处的数据进行分析，以比较等待名单上和胰腺移植后的患者生存率，并调查影响胰腺移植后患者生存的因素。
方法
对2000年至2018年12月期间接受胰腺移植的361例患者的生命预后进行了检查。
结果
等待名单上1年、5年和10年的生存率分别为98.4%、90.3%和78.1%，而移植后的生存率分别显著提高（P = 0.029）至100%、97.5%和88.9%。此外，等待胰肾联合移植（SPK）的患者1年、5年和10年的生存率分别为98.2%、89.4%和75.4%，而SPK后的生存率也显著提高（P = 0.026）至100%、94.6%和88.8%。多变量分析显示，术前糖尿病持续时间是影响SPK后患者生存的唯一独立危险因素（风险比 = 1.095，P = 0.012）。
结论
发现胰腺移植可改善1型糖尿病患者的生命预后，尤其是那些等待SPK的终末期肾衰竭患者。
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