Under Utilization of Pancreas Transplants in Cystic Fibrosis Recipients in the United Network Organ Sharing (UNOS) Data 1987-2014.
Under Utilization of Pancreas Transplants in Cystic Fibrosis Recipients in the United Network Organ Sharing (UNOS) Data 1987-2014.
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DOI：
10.1111/ajt.13630
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发表时间：
2016-05
期刊：
影响因子：
--
通讯作者：
Rosenthal P
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文献类型：
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作者：
Usatin DJ;Perito ER;Posselt AM;Rosenthal P
尽管囊性纤维化（CF）患者胰腺内分泌和外分泌功能不全的患病率很高，但胰腺移植很少报道。联合器官共享网络（UNOS）的数据用于检查CF患者的胰腺移植利用率和移植后结局。1987-2014年间，CF患者（N = 4600）接受了17例肝-胰腺、3例肺-胰腺、1例肝-肺-胰腺、4例肾-胰腺和3例仅胰腺移植。在接受肝移植的303例CF患者中，20%在移植前患有CF相关糖尿病（CFRD），其中9例接受了肝胰腺移植。在4241例接受肺移植的CF患者中，33%在移植前患有CFRD，其中3例接受了胰腺移植。在接受肝-肺移植的49例CF患者中，57%在移植前患有CFRD，1例接受胰腺移植。7%的CF胰腺移植受者发生了移植后糖尿病，24%的CF肝脏和29%的CF肺移植受者发生了移植后糖尿病。联合国器官共享网络没有关于胰腺外分泌功能不全的数据。肝-胰联合移植后2年生存率为88%，肺-胰联合移植后为33%，胰-肾联合移植和单纯胰腺移植后为100%。CF实体器官移植受者移植前和移植后糖尿病是常见的，但胰腺移植仍然罕见。在接受其他实体器官移植的CF患者中进一步考虑胰腺移植可能是必要的。
Despite a high prevalence of pancreatic endocrine and exocrine insufficiency in cystic fibrosis (CF), pancreas transplantation is rarely reported. United Network for Organ Sharing (UNOS) data were used to examine utilization of pancreas transplant and posttransplant outcomes in CF patients. Between 1987–2014, CF patients (N = 4600) underwent 17 liver–pancreas, three lung–pancreas, one liver–lung pancreas, four kidney–pancreas, and three pancreas-only transplants. Of the 303 CF patients who received liver transplantation, 20% had CF-related diabetes (CFRD) before transplantation, and nine of those received a liver–pancreas transplant. Of 4241 CF patients who underwent lung transplantation, 33% had CFRD before transplantation, and three of those received a pancreas transplant. Of 49 CF patients who received a liver–lung transplant, 57% had CFRD before transplantation and one received a pancreas transplant. Posttransplantation diabetes developed in 7% of CF pancreas transplant recipients versus 24% of CF liver and 29% of CF lung recipients. UNOS has no data on pancreas exocrine insufficiency. Two-year post-transplantation survival was 88% after liver–pancreas transplant, 33% after lung–pancreas transplant, and 100% after pancreas–kidney and pancreas-only transplants. Diabetes is common pretransplantation and posttransplantation in CF solid organ transplant recipients, but pancreas transplantation remains rare. Further consideration of pancreas transplant in CF patients undergoing other solid organ transplant may be warranted.