胰肾联合移植的体会

Clinical experience in the simultaneous pancreas-kidney transplantation

目的 总结胰肾联合移植的经验与教训。方法 回顾性分析 1例胰肾联合移植治疗的全过程和并发症。结果 糖尿病合并肾功能损害的病人 ,围手术期的并发症很多 ,有些并发症很凶险。手术顺利完成 ,移植的胰腺和肾脏功能都很好。绝大多数的并发症均被控制 ,只是口腔顽固性溃疡没有好办法 ,可能跟免疫抑制过量有关。术后 6 5 d发生大面积脑梗死 ,可能跟栓子脱落有关。结论 胰肾联合移植围手术期并发症的处理是管理的重点 ,应注意免疫抑制剂的个体化。

Objective The purpose of this study was to sum up experience and analyse problems of simultaneous pancreas-kidney (SPK) transplantation.Method The course of treatment from beginning to the end,including complications,was respectively analyzed in a patient undergoing SPK.Results The patient with type 1 diabetes and renal failure had much complications perioperatively,some of them were very severe.The SPK transplantation was done successfully,and the two grafts had very good function after the operation.Most of complications were cured,except intractable stomatocase and cerebral embolism.The former might be associated with over-dosage of immunosuppressive agents,the latter occurred 65 days after operation.Conclusion Control of perioperative complications is the focal point of SPK transplantation,and the dosage of immunosuppressive agents must be adjusted individually.