Baumgartner D, Largiadèr F
Zentralbl Chir. 1986;111(23):1450-5.
Simultaneous pancreas and kidney transplantation was applied to 22 type-I diabetics with diabetic nephropathy and other secondary complications, between July 1st, 1980 and November 30th, 1985. Four pancreas transplants, at present, are functional 56, 25, 15, and twelve months from transplantation. Six transplants lost their function within one and a half to 61 months from transplantation. The transplanted kidneys were immunologically rejected in four of these six cases. Four patients died with functioning transplants between 36 hours and eight months from transplantation. Three of them died of cardiac secondary sequels of their primary disease. In nine cases, pancreas transplants lost function within one month from transplantation without affecting functions of simultaneously transplanted kidneys. Most of the functional failures of transplants had been caused by ischaemic damage and postoperative vascular thrombosis. Complications from the exocrine pancreas were eliminated or avoided by postponement of percutaneous duct occlusion, using prolamine. The results reported in this paper show that for juvenile diabetics with nephropathy and ophthalmopathy simultaneous pancreas and kidney transplantation is the method of choice, whereas the course of the disease in patients with advanced secondary complications, such as severe angiopathy and gastropathy, could not be decisively improved by pancreas transplantation.
1980年7月1日至1985年11月30日期间，对22例患有糖尿病肾病及其他继发性并发症的I型糖尿病患者实施了胰肾联合移植。目前，有4例胰腺移植在移植后56、25、15和12个月仍功能良好。6例移植在移植后1个半月至61个月内失去功能。在这6例中，有4例移植肾发生了免疫排斥。4例患者在移植后36小时至8个月期间，移植器官功能良好，但患者死亡。其中3例死于原发性疾病的心脏继发性后遗症。9例患者的胰腺移植在移植后1个月内失去功能，同时移植的肾脏功能未受影响。移植器官的大多数功能衰竭是由缺血性损伤和术后血管血栓形成所致。通过使用醇溶谷蛋白推迟经皮导管闭塞，消除或避免了外分泌胰腺的并发症。本文报告的结果表明，对于患有肾病和眼病的青少年糖尿病患者，胰肾联合移植是首选方法，而对于患有严重血管病变和胃病等晚期继发性并发症的患者，胰腺移植并不能决定性地改善其病程。
