胰肾联合移植术5例及相关文献复习

Report of 5 simultaneous pancreas-kidney transplantation cases and review of relevant literature

目的:探讨胰肾联合移植手术供体获取、手术操作以及受者的预后。方法:青岛大学附属医院器官移植中心2019年8月至12月共累计为5例糖尿病合并终末期肾病患者施行胰肾联合移植,供体均为捐献者器官捐献,手术方式为供者髂动脉搭桥的腔静脉回流式胰肾联合移植术。观察受者的一般结果、术后外科并发症、术后1月并发症情况。结果:所有受者的移植胰腺及肾脏均于术后1周内恢复正常,均采用他克莫司+吗替麦考酚酯+激素联合免疫方案。所有受者均未出现需要外科干预的并发症。术后肺部感染2例,均呈急性间质性肺炎改变。结论:胰肾联合移植术为糖尿病合并终末期肾病患者提供了一种治疗方式,术后患者可摆脱降糖药物以及透析治疗,恢复生活质量。

Objective:To investigate the donor acquisition,operation and prognosis of pancreas-kidney transplantation.Methods:From August 2019 to December 2019,the organ transplantation center of affiliated hospital of Qingdao university performed Simultaneous pancreas-kidney transplantation in 5 patients with diabetes mellitus and end-stage renal disease.All the donors were DCD,and the surgical method was the donor iliac artery bypass vena cava reflux pancreas-kidney transplantation.The general results,postoperative surgical complications,and postoperative 1 month results were observed.Results:the function of transplanted pancreas and kidney returned to normal within 1 week.In all patients,TAC+MMF+prednisone combined immunization regimen was used.None of the patients developed complications that required surgical intervention.Postoperative pulmonary infection occurred in 2 patients with acute interstitial pneumonia.Conclusion:Simultaneous pancreas-kidney transplantation provides a new therapeutic approach for patients with diabetes mellitus with end-stage renal disease,and can benefit greatly from it.