胰腺移植的研究进展

Current status of pancreas transplantation

胰腺移植是治疗终末期糖尿病的可行性选择.40来,外科手术技术及免疫抑制的进步,显著促进了胰腺移植适应证的增加和移植物存活率的提高.胰腺移植能替代患者每天的胰岛素注射,提高生活质量,同时也需要复杂的手术操作和终生的免疫抑制治疗.因此发展创伤更小的内分泌替代治疗方法(胰岛移植)的研究一直在进行.本文概括地介绍了胰腺移植的适应证、供体选择、手术技术、免疫抑制和排斥的现状.

Pancreas transplantation has emerged as the treatment of choice for patients with end-stage diabetes mellitus. Over the last four decades, many improvements have been made in the surgical techniques and immunosuppressive regi- mens, which contributed to increased number of indications and improved allograft survival. Pancreas transplantation can be justifi ed on the basis that patients replace daily injections of insulin with an improved quality of life but at the expense of a major surgical procedure with a relatively higher complication rate, and lifelong immunosuppression. Therefore, efforts to develop more minimally invasive techniquesfor endocrine replacement therapy such as islet transplantation have been in progress. This article summarizes the current understanding of pancreas transplantation-associated indications, donor selection, surgical techniques, immuno- suppression, and rejection.