胎肝胎胰联合移植治疗IDDM的临床初步报告

FETAL LIVER AND PANCREAS COTRANSSPLANTATION IN THE TREATMENT OF TYPE I DIABELES MELLITUS

作者通过观察3例胎肝胎胰移植及术后定期胎肝组织块腹腔输注移植治疗IDDM女性患者1—2年发现,移植术后,病人糖尿病症状控制满意,月经恢复正常,一年胰岛素减少量均在50%以上,血清C肽较术前明显上升(P<0.01),并同时发现排斥反应时IL—2活性明显升高。结果表明:其疗效明显优于单一胎胰移植,其原因推测可能与胎肝组织块移植诱导的免疫抑制及免疫耐受有关。肝胎胰联合移植术后受者外周血IL—2活性增高可能是排斥反应监测的一个重要指标。

Three female patients with type I diabeles mellitus were treated by combined fetal pancreas and liver transplantation, followed postoperatively by periodic intraperitoned injection of fetal liver tissue suspension and observed for 1 to 2 years. It was found that, postoperatively the diabetic symptoms were satisfactorily controlled, menstruation returned to mormal, the amount of exogenous insulin required was reduced by more than 50% and serum C-peptide levels were significantly increased above preoperative levels, In addition, it was found that during rejection episodes, the IL-2 actioity increased. The resalfs showed that the therapeutio effect of the combined transplants were better than that of fetal pancreas transplant alone. The mechanism may be related to induction of im-munosappression and immunotolerance by-the fetal liver tissue grafts. Elevation of IL-2 in peripheral blood after combined transplantion of fetal liver and pancreas may serve as an important indicator in minitoring rejection.