Awata Takuya, Kenmochi Takashi, Tomimaru Yoshito, Eguchi Hidetoshi, Ito Toshinori, Shimoda Masayuki
Center for University-wide Education, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
The Central Coordination Committee of the Pancreas Transplantation in Japan, Tokyo, Japan.
Glob Health Med. 2020 Dec 31;2(6):360-366. doi: 10.35772/ghm.2020.01069.
In Japan, the first pancreas transplantation was performed in 1984 from a brain-dead donor; subsequently, however, the concept of brain death became a social issue. Thereafter, the "Organ Transplant Act", which enables brain-dead transplantation, was enacted in 1997, and then revised in 2010 so that donation after brain death became possible only with the consent of the family. Under the recipient selection and registration system developed after the enactment of the "Organ Transplant Act", more than 400 pancreas transplants have been carried out at facilities certified for brain-dead pancreas transplantation in Japan. Of the 410 total cadaveric pancreas transplants performed by the end of 2019, the patient survival and pancreatic and kidney graft survival rates were considered to be comparable to those in the United States and Europe despite the high frequency of marginal donors. Minimally invasive allogenic islet transplantation came to be covered by national health insurance in 2020 following good outcomes of a recent trial. Furthermore, to overcome the serious donor shortage in Japan, development of xenogeneic islet transplantation and regenerative medicine using stem cells is in progress, with xenotransplantation using porcine islets appearing particularly promising.
在日本，首例胰腺移植于1984年由脑死亡供体完成；然而，随后脑死亡的概念成为一个社会问题。此后，允许脑死亡器官移植的《器官移植法》于1997年颁布，并于2010年修订，以便只有在家属同意的情况下才能进行脑死亡后捐赠。在《器官移植法》颁布后建立的受者选择和登记系统下，日本经认证可进行脑死亡胰腺移植的机构已开展了400多例胰腺移植。截至2019年底进行的410例尸体胰腺移植中，尽管边缘供体的比例较高，但患者生存率以及胰腺和肾脏移植物生存率被认为与美国和欧洲相当。近期一项试验取得良好结果后，微创同种异体胰岛移植于2020年被纳入国民健康保险范围。此外，为克服日本严重的供体短缺问题，利用干细胞的异种胰岛移植和再生医学正在发展，使用猪胰岛的异种移植尤其具有前景。
