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The clinical study of kidney and pancreas transplantation (15 cases)
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF ORGAN TRANSPLANTATION
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.0254-1785.2007.04.001
- Key Word:
- 胰腺移植;肾移植;糖尿病,1型
Abstract： 目的 探讨1型糖尿病合并终末期肾病患者采用胰肾联合移植的效果.方法 回顾性总结1997年2月至2001年12月间15例患者进行胰肾联合移植的临床资料,对其手术方式、免疫抑制剂的应用、术后并发症以及1、3年人/胰腺/肾脏存活率进行统计.结果 15例患者中,采用胰肾联合移植(SPK)12例,肾移植后再行胰腺移植(PAK)3例;9例胰腺移植于腹膜外,6例移植于腹腔内;12例移植胰腺的外分泌液经膀胱引流,3例经肠道引流.患者术后均采用环孢素A或他克莫司+霉酚酸酯+激素的三联免疫抑制方案.12例患者(SPK 11例,PAK 1例)移植后早期的空腹血糖为4.4～7.8 mmol/L,无需应用胰岛素;3例应用胰岛素30～40 d后,移植胰、肾功能均恢复正常,停用胰岛素.12例经膀胱引流的患者其尿淀粉酶为760～117 000 U/L,血清淀粉酶为91～480 U/L.移植胰、肾共发生急性排斥反应5例次,总发生率为33.3%(5/15).1年人/胰腺/肾脏存活率(%)分别为60.0/53.3/60.0;3年为33.3/20.0/26.7;1例随访满5年,胰腺和肾脏功能基本正常.结论 胰肾联合移植可以有效治疗1型糖尿病合并尿毒症,术前应对患者作全面检查,制定最佳手术方案,以提高人/胰腺/肾脏的近、远期存活率.
- [1]明长生,陈忠华.胰腺与胰肾联合移植免疫抑制剂的应用[J].2004,(2).
- [2]明长生,甑忠广,曾凡军,等.32例胰、肾同期联合移植的近期疗效[J].2006,(1).
- [3]和不朗,管德林,高居忠.胰肾联合移植治疗I型糖尿病合并终末期肾病[J].2000,(8).
- [4]Juzhong G,Wu HX,Delin G,etc.Experience with combined pancreatic-renal transplantation using extraperitoneal placement.[J].2000,32(7).
- [5]管德林,高居忠,马潞林,等.胰肾联合移植治疗胰岛素依赖型糖尿病及终末期肾病的实验与临床研究[J].1998,(5).
- [6]Croce C,Boggi U,Mosca F,etc.Pancreas transplants from donors aged 45 years or older.[J].2005,37(2).
- [7]Saudek F,Malaise J,Adamec M,etc.Efficacy and safety of tacrolimus compared with cyclosporin microemulsion in primary SPK transplantation: 3-year results of the Euro-SPK 001 trial.[J].2005,20(Suppl.2).
- [8]Sung RS,Danovitch GM,Weir MR,etc.Current status of kidney and pancreas transplantation in the United States, 1994-2003.[J].2005,5(4 Pt.2).
- [9]Malaise J,Nakache R,Van Ophem D.A large, prospective, randomized, open-label, multicentre study of corticosteroid withdrawal in SPK transplantation: a 3-year report.[J].2005,20(Suppl.2).
- [10]Steurer W,Junker T,Boesmueller C,etc.Incidence of coronary heart disease and cardiac events in patients undergoing kidney and pancreatic transplantation.[J].2005,37(2).
- [11]Elmahdi A, Elkhammas,Mitchell L, Henry,Baris, Akin,etc.Simultaneous pancreas-kidney transplantation at a single center.[J].2003.
- [12]Helderman JH,Tanriover B,Ramanathan V,etc.Screening Asymptomatic Diabetic Patients for Coronary Artery Disease Prior to Renal Transplantation.[J].2005,79(10).
- [13]Nadey S, Hakim.Recent developments and future prospects in pancreatic transplantation.[J].2003,1(1).
- [14]E, Orsenigo,M, Cristallo,C, Socci,etc.[Simultaneous pancreas-kidney transplantation: a single center experience on 148 cases].[J].1900,75(5).
- [15]Arbogast H,Malaise J,Illner WD,etc.Rejection after simultaneous pancreas-kidney transplantation.[J].2005,20(Suppl.2).
- [16]Mark W,Berger N,Lechleitner M,etc.Impact of steroid withdrawal on metabolic parameters in a series of 112 enteric/systemic-drained pancreatic transplants.[J].2005,37(4).
- [17]Giral M,Karam G,Cantarovich D,etc.Steroid avoidance versus steroid withdrawal after simultaneous pancreas-kidney transplantation.[J].2005,5(6).
- [18]A, De Roover,O, Detry,C, Coimbra,etc.[Pancreas transplantation in the management of diabetes].[J].1900,60(5-6).