Larsen J L, Stratta R J
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3332, USA.
Diabetes Metab. 1996 Apr;22(2):139-46.
The success with which pancreas transplantation normalizes glucose concentration in patients with Type I diabetes mellitus has made it an important treatment option. Most pancreas transplant operations are performed in combination with a kidney transplant, and neither overall patient survival nor renal graft survival is compromised by the addition of a pancreas graft. Pancreas after kidney transplantation and isolated pancreas transplantation are performed less frequently since the pancreas graft success rate remains lower in these operations compared to combined pancreas-kidney transplantation. Pancreas transplantation improves the quality of life and stabilizes or reverses some diabetic microvascular complications, but its impact on the risk of atherosclerotic vascular disease is still unknown. The relative risks and benefits of pancreas transplantation need to be carefully assessed for each candidate through a thorough screening process, regardless of which type of graft is being considered. However, patient counseling and selection will be greatly aided by further research assessing the long-term risks and benefits of all types of pancreas transplantation. Pancreas transplantation will probably remain an important treatment option for some patients with Type I diabetes mellitus until this disease can either be successfully prevented or alternative treatment strategies are developed that provide equal glycaemic control with less or no associated immunosuppression.
胰腺移植能够使I型糖尿病患者的血糖浓度恢复正常，这一成功使其成为一种重要的治疗选择。大多数胰腺移植手术是与肾移植联合进行的，增加胰腺移植并不会影响患者的总体生存率和肾移植的存活率。肾移植后胰腺移植和单纯胰腺移植的开展频率较低，因为与胰肾联合移植相比，这些手术中胰腺移植的成功率仍然较低。胰腺移植可改善生活质量，并稳定或逆转一些糖尿病微血管并发症，但其对动脉粥样硬化性血管疾病风险的影响尚不清楚。无论考虑哪种类型的移植，都需要通过全面的筛查过程，为每位候选者仔细评估胰腺移植的相对风险和益处。然而，进一步评估各类胰腺移植长期风险和益处的研究，将极大地有助于患者咨询和选择。在I型糖尿病能够成功预防或开发出能提供同等血糖控制且免疫抑制较少或无免疫抑制的替代治疗策略之前，胰腺移植可能仍将是一些I型糖尿病患者的重要治疗选择。
