Sutherland D E, Moudry-Munns K, Gruessner A
Department of Surgery, University of Minnesota, Minneapolis.
Clin Transpl. 1993:47-69.
As of 1993, more than 5,000 pancreas transplants were reported to the International Pancreas Transplant Registry. More than 3,600 were performed in the USA, including 3,000 since the inception of the UNOS Registry in October, 1987. The BD technique was used for 96% of USA cases but for only 63% of non-USA cases. In the overall analysis of USA BD cadaveric pancreas transplants reported to the Registry by November 1993 (n = 2,464), patient survival and pancreas graft function survival rates at one year were 91% and 72%, respectively, 87% and 67% at 2 years, and 84% and 62% at 3 years. When the USA data for BD cases were analyzed according to the 3 major recipient categories (simultaneous pancreas/kidney transplants [SPK] [n = 2,112]; pancreas after kidney transplants [PAK] [n = 205]; and pancreas transplants alone [PTA] [n = 147]), patient survival rates were no different (91%, 92%, and 91% at one year, respectively), but pancreas graft survival rates were significantly higher in the SPK than in the PAK and PTA categories (76%, 47%, and 48%, at one year, respectively). In the SPK group, kidney graft survival rates at one year were 85%. Although the overall results were not as good for non-USA as for USA pancreas transplants, this was probably because the results with non-BD techniques were not as good as when BD was used, and in Europe more than one-third of the cases used techniques other than BD. The patient, pancreas, and kidney graft survival rates for BD SPK transplants in Europe (n = 522) and other non-USA locations (n = 64) were similar to those in the USA: in Europe 93%, 77%, and 84%, respectively, at one year. The graft survival rates for solitary pancreas transplants, however, were higher in the USA. Outcomes were also compared according to whether induction immunotherapy in USA recipients included ALG/ATG, OKT3, or neither. In the SPK category, there was no difference among the protocols: one-year graft survival rates were 76% with ALG/ATG (n = 1,141), 78% with OKT3 (n = 673), and 71% with neither (n = 249). In the PAK category, the use of OKT3 (n = 37) was associated with lower graft survival rates than when ALG/ATG (n = 133) or neither (n = 34) were given: 26%, 58%, and 53% at one year, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
截至1993年，国际胰腺移植登记处报告的胰腺移植超过5000例。美国进行了3600多例，其中自1987年10月美国器官共享联合网络（UNOS）登记处成立以来有3000例。在美国96%的病例使用了布罗德尔（BD）技术，而在非美国病例中仅为63%。在对1993年11月前向登记处报告的美国BD尸体胰腺移植（n = 2464）进行的总体分析中，患者1年生存率和胰腺移植物功能生存率分别为91%和72%，2年时为87%和67%，3年时为84%和62%。当根据3个主要受者类别（同时进行胰腺/肾脏移植[SPK][n = 2112]；肾移植后胰腺移植[PAK][n = 205]；以及单独胰腺移植[PTA][n = 147]）对美国BD病例数据进行分析时，患者生存率无差异（1年时分别为91%、92%和91%），但SPK组的胰腺移植物生存率显著高于PAK组和PTA组（1年时分别为76%、47%和48%）。在SPK组中，肾移植物1年生存率为85%。虽然非美国的总体结果不如美国胰腺移植的结果好，但这可能是因为非BD技术的结果不如使用BD技术时好，而且在欧洲超过三分之一的病例使用了BD以外的技术。欧洲（n = 522）和其他非美国地区（n = 64）BD SPK移植的患者、胰腺和肾移植物生存率与美国相似：欧洲1年时分别为93%、77%和84%。然而，单独胰腺移植的移植物生存率在美国更高。还根据美国受者诱导免疫治疗是否包括抗淋巴细胞球蛋白（ALG）/抗胸腺细胞球蛋白（ATG）、OKT3或两者都不包括来比较结果。在SPK类别中，各方案之间无差异：使用ALG/ATG（n = 1141）时1年移植物生存率为76%，使用OKT3（n = 673）时为78%，两者都不使用（n = 249）时为71%。在PAK类别中，使用OKT3（n = 37）与使用ALG/ATG（n = 133）或两者都不使用（n = 34）相比，移植物生存率较低：1年时分别为26%、58%和53%。（摘要截短于400字）
