Single-Center Experience with Pancreas Transplantation
Single-Center Experience with Pancreas Transplantation
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DOI：
10.1016/j.transproceed.2012.03.035
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发表时间：
2012-05-01
影响因子：
0.9
通讯作者：
Han, D. J.
中科院分区：
文献类型：
--
作者：
Park, J. B.;Kim, Y. H.;Han, D. J.
背景由于技术的改进以及更好的免疫抑制和术后管理，近年来胰腺移植（PT）患者和移植物存活率的提高以及术后发病率的降低迎来了。在此，我们分析了PT的结果超过19年的经验，在一个单一的中心。本研究纳入了1992年7月至2011年7月期间接受死亡供体或活体供体PT的所有受体。我们回顾了他们的医疗记录，包括手术记录，以及临床和实验室检查结果。我们使用Kaplan-Meier方法分析移植物和患者的存活率。1992年7月至2011年7月期间，共进行了153例手术。PT的适应症为125例（81.7%）患者的I型糖尿病和28例（18.3%）患者的II型糖尿病。供胰者死亡139例（90.8%），存活14例（9.2%）。PT类型为胰肾联合移植（n = 91，59.5%）、单纯胰腺移植（n = 49，32.0%）或肾后胰腺移植（n = 13，8.5%）。中位随访时间为43.0个月（范围0-228）。1年、5年和10年时，患者总生存率分别为93.8%、88.1%和85.1%，移植物生存率分别为82.3%、70.6%和64.6%。当我们将死亡的供体PT受体根据他们接受PT的时间分为两组（2005年之前[n = 54] vs 2006年及之后[n = 85]）时，最近的一组显示出患者和移植物存活率的显著提高（P <0.001）。I型（n = 65）和II型（n = 20）患者之间无差异（P = 0.159）。考虑到生活质量的改善和患者的长期生存，PT可以成为需要胰岛素的糖尿病患者的有效治疗策略，无论疾病类型如何。
Background. Recently improved patient and graft survivals, as well as decreased of postoperative morbidity have ushered in pancreas transplantation (PT) due to technical refinements as well as better immunosuppression and postoperative management. Herein we analyzed the outcomes of PT over a 19-year experiences at a single center.Methods. All recipients who underwent deceased donor or living donor PT from July 1992 to July 2011 were enrolled in this study. We reviewed their medical records, including operative records, as well as clinical and laboratory findings. We analyzed graft and patient survival rates using the Kaplan-Meier method.Results. One hundred fifty-three cases were performed between July 1992 and July 2011. The indication for PT was type I diabetes in 125 (81.7%), and type II diabetes in 28 (18.3%) patients. The pancreas donor was deceased in 139 (90.8%) and living in 14 cases (9.2%). The type of PT was simultaneous pancreas-kidney transplantation (n = 91, 59.5%), pancreas alone (n = 49; 32.0%), or pancreas after kidney (n = 13, 8.5%). Median follow-up was 43.0 months (range 0-228). At 1, 5, and 10 years overall patient survivals were 93.8%, 88.1%, and 85.1%, and graft survivals, 82.3%, 70.6%, and 64.6%, respectively. When we divided the deceased donor PT recipients into two groups according to when they underwent PT (up to 2005 [n = 54]) vs 2006 and later [n = 85]), the recent group showed significantly improved patient and graft survival rates (P < .001). With no difference between type I (n = 65) and type II (n = 20) patients (P = .159).Conclusion. Considering the improved quality of life and long-term patient survival, PT can be an effective treatment strategy in diabetic patients requiring insulin regardless of type of disorder.