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美国的单独胰腺移植:我们处于什么位置?

Pancreas Transplant Alone in the USA, Where Do We Stand?

机构信息

Division of Transplant Services, Department of Surgery, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA.

出版信息

World J Surg. 2023 Sep;47(9):2250-2258. doi: 10.1007/s00268-023-07062-w. Epub 2023 May 31.

Abstract

BACKGROUND

Currently, over 63,000 pancreas transplant procedures have been performed worldwide, with only approximately 8% of all pancreas transplants having been a pancreas transplant alone. Our study aimed to quantify outcomes following pancreas transplant alone in the United States from 2001 to 2020, with an emphasis on graft and patient survival.

METHODS AND MATERIALS

We performed a retrospective registry analysis utilizing the OPTN/UNOS database for pancreas transplants alone performed in the United States from January 2001 to May 2020 to assess transplant outcomes. The study population was divided into two subgroups: patients receiving a pancreas transplant between 2000 and 2009 and those receiving a pancreas transplant between 2010 and 2020.

RESULTS

3008 allograft recipients were included in the study. 1679 (54.87%) transplants were done from January 2000 to the end of 2009. 1381 (45.13%) transplants were done from 2010 to May 2020. Although the BMI and recipient sex comparison indicate a statistically significant difference, the differences are not clinically significant. The overall 5-year allograft survival rate was 52.17% in the 2000-2009 group, which increased to 58.82% in pancreas transplants alone from 2010 to 2020 (P = 0.02). The overall 5-year patient survival rate was 74.52% in the 2000-2009 group, which increased to 74.92% in pancreas transplants alone from 2010 to 2020 (P = 0.81).

CONCLUSION

With all the progress in terms of surgical techniques, organ allocation and preservation, and immunosuppressive regimens, the pancreas transplant alone allograft survival has been improving over the years, although it has been still being underutilized around the US.

摘要

背景

目前,全球已完成超过 63000 例胰腺移植手术,其中仅有约 8%为单纯胰腺移植。本研究旨在量化 2001 年至 2020 年期间美国单纯胰腺移植的结果,重点关注移植物和患者的存活率。

方法和材料

我们利用 OPTN/UNOS 数据库对 2001 年 1 月至 2020 年 5 月期间在美国进行的单纯胰腺移植进行回顾性登记分析,以评估移植结果。研究人群分为两组:2000 年至 2009 年接受胰腺移植的患者和 2010 年至 2020 年接受胰腺移植的患者。

结果

共有 3008 例同种异体移植物受者纳入本研究。其中,1679 例(54.87%)移植手术于 2000 年 1 月至 2009 年底进行。1381 例(45.13%)移植手术于 2010 年至 2020 年 5 月进行。尽管 BMI 和受者性别比较显示存在统计学显著差异,但差异无临床意义。2000-2009 年组的 5 年总体移植物存活率为 52.17%,而 2010-2020 年单纯胰腺移植组的存活率提高至 58.82%(P=0.02)。2000-2009 年组的 5 年总体患者存活率为 74.52%,而 2010-2020 年单纯胰腺移植组的存活率提高至 74.92%(P=0.81)。

结论

尽管在手术技术、器官分配和保存以及免疫抑制方案方面取得了所有进展,但单纯胰腺移植的移植物存活率近年来一直在提高,尽管在美国仍未得到充分利用。

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