Short- and long-term outcome for living pancreas donors
Short- and long-term outcome for living pancreas donors
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DOI：
10.1007/s00534-009-0147-x
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发表时间：
2010-03-01
影响因子：
3
通讯作者：
Gruessner, Rainer W. G.
中科院分区：
文献类型：
--
作者：
Reynoso, Jason F.;Gruessner, Christine E.;Gruessner, Rainer W. G.
活体胰腺移植对受者的优点包括良好的HLA匹配、较低的免疫风险、较少的免疫抑制、较低的感染和移植后恶性肿瘤的风险以及较短的胰腺移植物保存时间。 2008年，国际胰腺移植登记处共报告了来自6个国家的155例活体胰腺移植手术。胰腺活体捐献者需要接受彻底的移植前内分泌检查，以尽量减少代谢并发症的风险。初步报告显示，高达 25% 的活体捐献者在捐献后血红蛋白 A(1c) 水平升高，移植前检查随着时间的推移而不断发展。捐赠后避免肥胖可以降低长期代谢并发症的风险。供体发生手术并发症（如胰腺炎、胰漏或瘘、胰腺脓肿、胰腺假性囊肿）的风险低于5%。如果供体和受者手术在技术上均成功，则活体（与已故）供体胰腺移植受者的长期移植物存活率显着更高。未来有必要对活体供体的代谢功能进行长期研究，以确定活体供体胰腺移植是否可以安全地更广泛地应用以及活体供体是否可以用于胰岛移植。
The advantages of living donor pancreas transplants for the recipient include good HLA matching, lower immunologic risk, less immunosuppression, lower risk of infection and of posttransplant malignancies, and shorter pancreas graft preservation time. In 2008, a total of 155 segmental pancreas transplants using living donors were reported to the International Pancreas Transplant Registry from six countries. Pancreas living donors need to undergo a thorough pretransplant endocrinologic workup in order to minimize the risk of metabolic complications. The pretransplant workup has evolved over time, after initial reports showed that up to 25% of living donors had elevated hemoglobin A(1c) levels after donation. Avoiding obesity after donation diminishes the risk of long-term metabolic complications. The risk of surgical complications for the donor (such as pancreatitis, pancreatic leak or fistula, pancreatic abscess, and pancreatic pseudocyst) is less than 5%. If both the donor and recipient operations are technically successful, the long-term graft survival rate is significantly higher for living (versus deceased) donor pancreas transplant recipients. Future long-term studies of metabolic function in living donors are warranted to determine whether living donor pancreas transplants can safely be applied more widely and whether living donors can be used for islet transplants.