Downstate Health Sciences University, Brooklyn, New York.
Downstate Health Sciences University, Brooklyn, New York.
Transplant Proc. 2022 Sep;54(7):1918-1943. doi: 10.1016/j.transproceed.2022.03.059. Epub 2022 Aug 13.
Over the last decades, the number of pancreas transplants has increased all over the world. Since the first pancreas transplant in 1966, patient and graft survival after simultaneous pancreas and kidney as well as after solitary pancreas transplantation have improved significantly. Patient survival at 1 year is >96% in all 3 recipient categories and pancreas graft survival is >90% for simultaneous pancreas and kidney and >86% for solitary transplants. For transplants performed between 2001 and 2010, with >10 years' follow-up time, the half-life (50% graft function) was 13 years for simultaneous pancreas and kidney, almost 10 years for a pancreas after kidney transplant, and >6 years for a pancreas transplant alone. These excellent results are even more astonishing because more high-risk patients were transplanted. The main reasons for improvement in outcome were reductions in technical failures and immunologic graft losses. These decreases were due to better patient and donor selection, standardization of surgical techniques, and superior immunosuppressive protocols.
在过去几十年中，全世界的胰腺移植数量有所增加。自 1966 年首例胰腺移植以来，胰肾联合移植和单纯胰腺移植后的患者和移植物存活率都有显著提高。在所有 3 类受者中，1 年患者存活率>96%，胰肾联合移植的胰腺移植物存活率>90%，单纯胰腺移植的胰腺移植物存活率>86%。对于在 2001 年至 2010 年间进行、随访时间超过 10 年的移植，胰肾联合移植的半衰期（50%移植物功能）为 13 年，肾移植后胰腺的半衰期约为 10 年，单纯胰腺移植的半衰期>6 年。这些出色的结果更令人惊讶，因为有更多高风险的患者接受了移植。结果改善的主要原因是技术失败和免疫性移植物丢失的减少。这些减少是由于更好的患者和供者选择、手术技术的标准化以及更优的免疫抑制方案。
