Whole-Organ Pancreas and Islets Transplantations in UK: An Overview and Future Directions.
Whole-Organ Pancreas and Islets Transplantations in UK: An Overview and Future Directions.
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DOI：
10.3390/jcm12093245
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发表时间：
2023-05-01
影响因子：
3.9
通讯作者：
Sutherland, Andrew
中科院分区：
文献类型：
--
作者：
Martin, David;Alberti, Piero;Demartines, Nicolas;Phillips, Melanie;Casey, John;Sutherland, Andrew
全器官胰腺和胰岛移植是治疗1型糖尿病患者的两种治疗选择，这些患者对优化的药物治疗有抵抗力，并出现严重的并发症。β细胞替代的最佳选择取决于几个因素，如肾功能，患者合并症和治疗目标。对于患有终末期肾病的患者，选择的治疗通常是胰腺和肾脏（SPK）的同时移植。然而，它仍然是一个主要的外科手术在患者有多种合并症，因此它是重要的，以选择那些谁将受益于它。此外，鉴于器官短缺，新的战略，以改善结果和减少免疫反应已经开发，包括动态器官灌注技术，胰腺生物工程，干细胞疗法。本文就全器官胰腺和胰岛移植的适应证、手术技术、结果和未来发展方向作一综述。
Whole-organ pancreas and islets transplantations are two therapeutic options to treat type 1 diabetic patients resistant to optimised medical treatment in whom severe complications develop. Selection of the best option for β-cell replacement depends on several factors such as kidney function, patient comorbidities, and treatment goals. For a patient with end-stage kidney disease, the treatment of choice is often a simultaneous transplant of the pancreas and kidney (SPK). However, it remains a major surgical procedure in patients with multiple comorbidities and therefore it is important to select those who will benefit from it. Additionally, in view of the organ shortage, new strategies to improve outcomes and reduce immune reactions have been developed, including dynamic organ perfusion technologies, pancreas bioengineering, and stem cell therapies. The purpose of this article is to review the indications, surgical techniques, outcomes, and future directions of whole-organ pancreas and islets transplantations.
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