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Establishment of simultaneous pancreas and kidney transplantation (SPK) model with cuff technique and portal venous drainage in rats
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作者 Shuguang Han Zekuan Xu Xuan Zhang Yi Miao 《Journal of Nanjing Medical University》 2007年第1期8-10,共3页
To establish a simultaneous pancreas and kidney transplantation (SPK) model in the rat. Methods: SD rats served as donors and recipients. The donor portal vein and the recipient superior mesenteric vein were anasto... To establish a simultaneous pancreas and kidney transplantation (SPK) model in the rat. Methods: SD rats served as donors and recipients. The donor portal vein and the recipient superior mesenteric vein were anastomosed and the donor renal veins and recipient renal veins were anastomosed by cuff method. Arterial reconstruction was carried out by end to side anastomosis of the donor abdominal aorta to the recipient abdominal aorta. Enteric drainage was performed by side to side anastomosis between donors' duodenum and recipients' jejunum. The donor ureter -bladder valve was anastomosed to the bladder of recipients. Results: Out of 30 cases of SPK transplantation, 24 had normal serum glucose and serum creatinine after operation. The successful rate was 80 %. Conclusion: This model of SPK in rats is stable and reliable, which could be applied for further scientific research. 展开更多
关键词 simultaneous pancreas and kidney transplantation RAT MODEL
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Mortality assessment for pancreas transplants in the United States over the decade 2008-2018
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作者 Tambi Jarmi Emily Brennan +1 位作者 Jacob Clendenon Aaron C Spaulding 《World Journal of Transplantation》 2023年第4期147-156,共10页
BACKGROUND Pancreas transplant is the only treatment that establishes normal glucose levels for patients diagnosed with diabetes.However,since 2005,no comprehensive analysis has compared survival outcomes of:(1)Simult... BACKGROUND Pancreas transplant is the only treatment that establishes normal glucose levels for patients diagnosed with diabetes.However,since 2005,no comprehensive analysis has compared survival outcomes of:(1)Simultaneous pancreas-kidney(SPK)transplant;(2)Pancreas after kidney(PAK)transplant;and(3)Pancreas transplant alone(PTA)to waitlist survival.AIM To explore the outcomes of pancreas transplants in the United States during the decade 2008-2018.METHODS Our study utilized the United Network for Organ Sharing Standard Transplant Analysis and Research file.Pre-and post-transplant recipient and waitlist characteristics and the most recent recipient transplant and mortality status were used.We included all patients with type I diabetes listed for pancreas or kidneypancreas transplant between May 31,2008 and May 31,2018.Patients were grouped into one of three transplant types:SPK,PAK,or PTA.RESULTS The adjusted Cox proportional hazards models comparing survival between transplanted and non-transplanted patients in each transplant type group showed that patients who underwent an SPK transplant exhibited a significantly reduced hazard of mortality[hazard ratio(HR)=0.21,95%confidence intervals(CI):0.19-0.25]compared to those not transplanted.Neither PAK transplanted patients(HR=1.68,95%CI:0.99-2.87)nor PTA patients(HR=1.01,95%CI:0.53-1.95)experienced significantly different hazards of mortality compared to patients who did not receive a transplant.CONCLUSION When assessing each of the three transplant types,only SPK transplant offered a survival advantage compared to patients on the waiting list.PKA and PTA transplanted patients demonstrated no significant differences compared to patients who did not receive a transplant. 展开更多
关键词 pancreas transplant simultaneous pancreas-kidney transplant pancreas after kidney transplant Survival Diabetes mellitus INSULIN
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胰肾联合移植中供体切取和修整的技巧 被引量:3
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作者 宋少伟 刘永锋 《中国普通外科杂志》 CAS CSCD 2008年第3期267-269,共3页
目的总结胰肾一期联合移植中供体胰十二指肠及肾脏切取及修整的经验。方法回顾性分析19例胰肾联合移植术中供体胰十二指肠及肾脏切取的方法与移植物的修整技巧。结果无1例发生移植物损伤。联合移植术后9d之内18例完全停用外源性胰岛素... 目的总结胰肾一期联合移植中供体胰十二指肠及肾脏切取及修整的经验。方法回顾性分析19例胰肾联合移植术中供体胰十二指肠及肾脏切取的方法与移植物的修整技巧。结果无1例发生移植物损伤。联合移植术后9d之内18例完全停用外源性胰岛素,空腹血糖正常,尿糖≤(+)。术后2~4d,血肌酐和尿素氮降至正常。3例出现移植肾脏急性排斥反应,2例发生移植胰腺急性排斥反应,给予甲泼尼龙冲击治疗后恢复正常。1例术后因移植物加速排斥反应,术后11d切除移植胰、肾。结论胰肾联合移植手术中,供体胰十二指肠及肾脏的切取及修整是手术成功的重要因素之一。 展开更多
关键词 胰肾联合移植 移植物 胰十二指肠 器官移植/方法
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移植胰腺病理学诊断标准及其进展 被引量:1
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作者 郭晖 明长生 陈实 《器官移植》 CAS CSCD 北大核心 2022年第2期176-186,共11页
胰腺移植和胰肾联合移植是治疗1型糖尿病和部分2型糖尿病及其并发症导致的肾衰竭的最佳治疗方法。胰腺移植的类型主要包括同期胰肾联合移植(SPK)、肾移植后胰腺移植(PAK)和单纯胰腺移植(PTA)。在所有的胰腺移植类型中,对移植胰腺的活组... 胰腺移植和胰肾联合移植是治疗1型糖尿病和部分2型糖尿病及其并发症导致的肾衰竭的最佳治疗方法。胰腺移植的类型主要包括同期胰肾联合移植(SPK)、肾移植后胰腺移植(PAK)和单纯胰腺移植(PTA)。在所有的胰腺移植类型中,对移植胰腺的活组织检查(活检)仍然是明确诊断其排斥反应并与其他并发症进行鉴别的最佳方法。本文对移植胰腺活检的方法及其相关的研究进展、移植胰腺活检排斥反应诊断标准及其进展、移植胰腺主要的并发症及其病理学表现进行阐述,旨在为指导临床对上述并发症予以准确诊断,良好地保障移植胰腺和受者的长期存活提供参考。 展开更多
关键词 同期胰肾联合移植(spk) 肾移植后胰腺移植(PAK) 单纯胰腺移植(PTA) 抗体介导的排斥反应(AMR) T细胞介导的排斥反应(TCMR) 供者特异性抗体(DSA) 慢性移植物动脉血管病(CTA) 移植后淋巴组织增生性疾病(PTLD)
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胰肾联合移植治疗糖尿病肾功能衰竭五例临床分析 被引量:2
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作者 任生生 许亮亮 +4 位作者 宋涂润 张鸣 林涛 徐明清 Li Shifeng 《中华器官移植杂志》 CAS 北大核心 2019年第5期272-276,共5页
目的总结胰肾联合移植(SPK)围手术期及出院后随访期处理经验,降低SPK术后并发症发生,提高SPK临床效果。方法回顾性分析2017年11月至2018年10月5例因糖尿病肾功能衰竭接受SPK术受者的临床资料、围手术期及出院后随访期资料。结果5例受者... 目的总结胰肾联合移植(SPK)围手术期及出院后随访期处理经验,降低SPK术后并发症发生,提高SPK临床效果。方法回顾性分析2017年11月至2018年10月5例因糖尿病肾功能衰竭接受SPK术受者的临床资料、围手术期及出院后随访期资料。结果5例受者供胰、供肾冷缺血时间均控制在8 h内,围手术期无外科技术性出血、肠瘘、动静脉大血栓、坏死性胰腺炎等并发症发生。1例术后原发性移植肾功能恢复延迟经血液透析后逐渐康复;2例术后因抗凝而发生移植胰腺区域腹腔内渗血,经药物促凝治疗后止血成功,但其中1例导致继发性肾功能障碍,经透析和调整免疫抑制剂剂量后逐渐恢复;1例术后因抗凝而发生消化道出血,经药物促凝治疗后停止;3例术后1周后常规移植物彩色超声检查发现移植胰腺内血管小血栓形成,经抗凝治疗后消失或稳定好转;1例移植肾周积液感染经局麻清创引流后康复;2例术后出现高钾血症经治疗后血钾恢复正常;1例术后第45天突发急性左心功能衰竭,经心肺复苏后恢复自主心率,但意识未恢复,1周后受者家属放弃治疗出院;其余4例受者术后血糖与血肌酐水平完全恢复正常且脱离外源性胰岛素使用与透析,康复出院,其中1例在术后143 d出现急性排斥反应经激素冲击治疗后缓解。随访至2019年3月20日,目前存活的4例受者空腹血糖及血肌酐水平均正常,糖尿病并发症得以缓解或改善。结论SPK是治疗糖尿病肾功能衰竭的有效手段,能使受者脱离胰岛素及维持性透析,改善糖尿病并发症,从而明显提高受者的生活质量。 展开更多
关键词 胰肾联合移植 糖尿病 肾功能衰竭 围手术期管理
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