Morel P H, Bühler L, Marini M, Deng S, Mage R, Mentha G, Rohner A
Département de chirurgie, Hôpital cantonal universitaire de Genève.
Helv Chir Acta. 1993 Jun;59(5-6):901-9.
Islet of Langerhans transplantation is an alternative to whole pancreas transplantation for type I diabetic patients, in whom exogenous insulin therapy has not prevented the occurrence of systemic complications. Thanks to a new isolation technique of human islets, 45 patients have been transplanted worldwide since 1988, of whom only 7 have become totally insulin-independent. Rejection and quality of the islet preparations are problems which remain to be solved. Autotransplantation of islets has been proposed in patients undergoing a pancreatectomy for benign disease. The present report concerns two of our patients who had a pancreatectomy with islet autotransplantation. Both patients are insulin-independent 3 and 11 months postoperatively, with satisfactory metabolic tests. Islet autotransplantation can be proposed when pancreatectomy for non-malignant disease is performed. This method may prevent the development of insulin-dependent diabetes, known to be particularly labile. Because of the sophisticated technical procedures required, human islet isolation is at present only performed in a small number of medical centers and still is in the field of medical experimentation.
胰岛移植是I型糖尿病患者全胰腺移植的一种替代方法，这些患者接受外源性胰岛素治疗仍未能预防全身并发症的发生。得益于一种新的人胰岛分离技术，自1988年以来全球已有45例患者接受了胰岛移植，其中只有7例完全不再依赖胰岛素。排斥反应和胰岛制剂质量仍是有待解决的问题。对于因良性疾病接受胰腺切除术的患者，有人提出进行胰岛自体移植。本报告涉及我们的两名接受胰腺切除并进行胰岛自体移植的患者。两名患者术后3个月和11个月均不再依赖胰岛素，代谢测试结果令人满意。当因非恶性疾病进行胰腺切除术时，可以考虑进行胰岛自体移植。这种方法可能预防已知特别不稳定的胰岛素依赖型糖尿病的发展。由于所需技术程序复杂，目前人胰岛分离仅在少数医疗中心进行，且仍处于医学实验阶段。
