Li Cheukfai, Zhang Wei, Zhao Qiang, Ye Maodong, Ju Weiqiang, Wu Linwei, Ma Yi, Hu Anbin, Wang Guodong, Zhu Xiaofeng, Guo Zhiyong, Wang Dongping, He Xiaoshun
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Science, Guangzhou, China.
Front Med (Lausanne). 2020 Oct 19;7:542905. doi: 10.3389/fmed.2020.542905. eCollection 2020.
This study was intended to summarize the characteristics and clinical outcome of Liver and Pancreas (LPTx) recipients in the Scientific Registry of Transplant Recipients (SRTR) database vs. the largest series from the First Affiliated Hospital (FAH), Sun Yat-sen University. The clinical data of 23 patients who underwent LPTx from 2000 to 2016 in the United States and 31 patients who underwent modified LPTx procedure (known as simplified multivisceral transplantation [SMT]) from 2008 to 2017 in our center were reviewed. The indications, surgical techniques, patient and graft survival, and complications were compared between the two groups. All recipients in the FAH group were diagnosed with type 2 diabetes mellitus, while 10 of 23 recipients were diagnosed with type 1 diabetes mellitus in the SRTR group. The 1-, 3-, and 5-year cumulative patient survival rates were 81, 74, and 74% in the FAH group, respectively, and 51, 47, and 37% in the SRTR group, respectively ( = 0.023). No diabetes was observed during follow-up in the FAH group, while the diabetes recurrence rate was 22.2% in the SRTR group ( = 0.03). With multiple techniques modified and indications changed, the SMT procedure yielded a preferable outcome compared to that of the traditional LPTx procedure in records of SRTR. SMT has become a treatment option for patients with end-stage liver disease and concurrent diabetes.
本研究旨在总结移植受者科学注册系统（SRTR）数据库中肝胰联合移植（LPTx）受者与中山大学附属第一医院（FAH）最大系列病例的特征及临床结局。回顾了2000年至2016年在美国接受LPTx的23例患者以及2008年至2017年在本中心接受改良LPTx手术（即简化多脏器移植[SMT]）的31例患者的临床资料。比较了两组患者的适应证、手术技术、患者及移植物生存率和并发症情况。FAH组所有受者均诊断为2型糖尿病，而SRTR组23例受者中有10例诊断为1型糖尿病。FAH组1年、3年和5年累积患者生存率分别为81%、74%和74%，SRTR组分别为51%、47%和37%（P = 0.023）。FAH组随访期间未观察到糖尿病复发，而SRTR组糖尿病复发率为22.2%（P = 0.03）。随着多种技术的改良和适应证的改变，在SRTR记录中，SMT手术与传统LPTx手术相比取得了更好的结局。SMT已成为终末期肝病合并糖尿病患者的一种治疗选择。
