Recovery of endocrine function after islet and pancreas transplantation.
Recovery of endocrine function after islet and pancreas transplantation.
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DOI：
10.1007/s11892-012-0294-3
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发表时间：
2012-10
影响因子：
4.2
通讯作者：
Rickels, Michael R.
中科院分区：
文献类型：
--
作者：
Rickels, Michael R.
关键词：
Type 1 diabetesC-peptide responseFunctional beta-cell massbeta-cell secretory capacityInsulin secretionInsulin sensitivityProinsulin secretionGlucagon secretionGlucose counter-regulationHypoglycemia unawarenessImmunosuppression drugsPrednisoneTacrolimusSirolimusMycophenolateEndocrine functionIslet and pancreas transplantation
长期存在的 1 型糖尿病 (T1D) 与内源性胰岛素分泌的绝对丧失（循环 C 肽检测不到）以及葡萄糖反调节的相关缺陷有关，这种缺陷通常会因无意识的低血糖而变得复杂，从而显着增加严重低血糖的风险。离体胰岛移植和全胰移植均可恢复β细胞分泌能力，改善血糖反调节，恢复低血糖意识，从而缓解严重低血糖。胰岛移植可能需要多个供体胰腺，目前看来，整个胰腺的内分泌功能恢复更为持久；然而，胰岛移植的结果正在稳步改善。由于并非所有患有严重低血糖的 T1D 患者都适合接受全胰腺，而且并非所有胰腺在技术上都适合全器官移植，因此胰岛和胰腺移植正在发展成为问题最严重的 T1D 患者恢复内分泌功能的补充方法。
Long-standing type 1 diabetes (T1D) is associated with an absolute loss of endogenous insulin secretion (circulating C-peptide is undetectable) and a related defect in glucose counterregulation that is often complicated by hypoglycemia unawareness, markedly increasing the risk for severe hypoglycemia. Both the transplantation of isolated islets and a whole pancreas can restore β-cell secretory capacity, improve glucose counterregulation, and return hypoglycemia awareness, thus alleviating severe hypoglycemia. The transplantation of islets may require more than one donor pancreas, and the recovery of endocrine function for now appears more durable with a whole pancreas; however, islet transplantation outcomes are steadily improving. Because not all patients with T1D experiencing severe hypoglycemia are candidates to receive a whole pancreas, and since not all pancreata are technically suitable for whole organ transplantation, islet and pancreas transplantation are evolving as complementary approaches for the recovery of endocrine function in patients with the most problematic T1D.
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