Department of Surgery, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Am J Transplant. 2022 Sep;22(9):2265-2268. doi: 10.1111/ajt.17042. Epub 2022 Apr 2.
The subset of the population that received bladder-drained allograft pancreata during peak utilization of the technique in the 1990s is approaching 20-30 postoperative years. This time frame is salient, as it parallels the time in which patients in the urologic literature develop adenocarcinomas after bladder reconstruction using gastrointestinal segments. We present the case of a 57-year-old simultaneous pancreas/kidney recipient who presented with microhematuria twenty-four years after transplantation and was found to have an adenocarcinoma of the duodenum of his failed, bladder-drained pancreas. After allograft pancreatectomy/duodenectomy, he remains disease-free eleven months postoperatively. As this patient population ages, practitioners should consider pathology of the donor duodenum and pancreas in recipients who present with gross or microscopic hematuria.
在 20 世纪 90 年代该技术的使用高峰期，接受经膀胱引流的同种异体胰腺移植的人群中，有一部分人已经接近术后 20-30 年。这个时间框架很重要，因为它与泌尿科文献中报道的使用胃肠道段进行膀胱重建后患者发生腺癌的时间相吻合。我们报告了一例 57 岁的胰肾联合移植受者，他在移植后 24 年出现镜下血尿，并被发现患有失败的经膀胱引流的胰腺中的十二指肠腺癌。行同种异体胰腺切除术/十二指肠切除术治疗后，患者术后 11 个月无疾病复发。随着这一患者人群的老龄化，对于出现肉眼血尿或镜下血尿的受者，临床医生应该考虑供体十二指肠和胰腺的病理情况。
