Kubota K, Makuuchi M
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1996 Nov;97(11):984-9.
Pancreas transplantation has been established as a treatment option for type I diabetes mellitus with one-year patients survival rate of 91% and one-year graft survival rate of 71%. Simultaneous pancreas and kidney transplantation with the bladder-drainage technique is most frequently performed. The bladder drainage technique makes amylase activity measurement in the urine as well as urine cytology possible, which facilitate a diagnosis of acute rejection. Combination treatment with cyclosporine, azatioprine, steroid and anti-lymphocyte globulin is usually employed for immunosuppression. In addition, FK506 in now available and expected to contribute to better graft survival. In contrast, islet transplantation has not yet achieved satisfactory results. Although a large number of islets can now be obtained from one pancreas, they are not sufficient for stabilizing a diabetic condition and multiple donors are still required. Xeno-transplantation may resolve the problem. Both pancreas and islet transplantation will achieve better results with further advance of transplant techniques including immunosuppressive treatment and diagnostic methods for acute rejection.
胰腺移植已成为治疗I型糖尿病的一种选择，患者一年生存率为91%，移植器官一年生存率为71%。最常采用的是膀胱引流技术进行同期胰腺和肾脏移植。膀胱引流技术使得尿液淀粉酶活性测定以及尿细胞学检查成为可能，这有助于急性排斥反应的诊断。免疫抑制通常采用环孢素、硫唑嘌呤、类固醇和抗淋巴细胞球蛋白联合治疗。此外，现在已有FK506，预计它将有助于提高移植器官的存活率。相比之下，胰岛移植尚未取得令人满意的结果。尽管现在从一个胰腺可以获取大量胰岛，但这些胰岛仍不足以稳定糖尿病病情，仍然需要多个供体。异种移植可能解决这一问题。随着移植技术（包括免疫抑制治疗和急性排斥反应诊断方法）的进一步发展，胰腺和胰岛移植都将取得更好的效果。
