胰肾联合移植治疗老年2型糖尿病合并终末期肾病  

Simultaneous Pancreas-kidney Transplantation (SPK) for an Old Age Male with Type 2 Diabetes Complicated with End Stage Renal Disease (ESRD):a Case Report

作　　者：田伯乐[1] 张肇达[1] 刘续宝[1] 胡伟明[1] 韩方海[1] 麦刚[1] 赵继春[1] 王莉[2] 任燕[3] 陆慧敏[1] 罗朝志[4] 罗传兴[5] 袁朝新[6] 陆燕蓉[7] 

机构地区：[1]四川大学华西医院普外科,成都610041 [2]四川大学华西医院泌尿外科 [3]四川大学华西医院内分泌科 [4]四川大学华西医院麻醉科 [5]四川大学华西医院ICU [6]四川大学华西医院超声诊断科 [7]四川大学华西医院移植免疫研究室

出　　处：《四川大学学报（医学版）》2007年第6期1050-1052,共3页Journal of Sichuan University(Medical Sciences)

基　　金：四川大学华西医院新技术开发基金资助

摘　　要：四川大学华西医院于2007年3月对一位65岁高龄的2型糖尿病患者成功施行了胰肾联合移植手术。患者为男性,患2型糖尿病史15年,合并肾功能衰竭5年,并出现糖尿病眼底病变、周围神经损害等症状。手术将供肾移植于左侧髂窝,供胰移植于右侧髂窝,胰腺外分泌引流采用经肠道、内分泌回流采用经体循环途径的术式。术后第1dC-肽即达正常水平,第4d血肌酐恢复正常,第11d血尿素氮恢复正常;血糖逐渐趋于稳定,第16d完全停用胰岛素。术后3周OGTT结果显示移植胰腺功能正常。无任何并发症。术后随访6月余,血糖稳定,完全停用胰岛素,肾功能正常,视力也有一定程度的恢复。We reported the first case of simultaneous pancreas-kidney transplantation （SPK） in our hospital, The recipient is a 65 year old male, who suffered type 2 diabetes for 15 years and renal dysfunction for 5 years and other diabetic complications such as retinopathy, peripheral neuropathy. SPK was performed successfully for him in March, 2007, in which the donor kidney was put in left iliac fossa, while the donor pancreas grafted to set in right iliac fossa of recipient, with pancreas exocrine drainage controlled by anastomosis to the small bowel and endocrine release done to the circulatory system, Serum C-peptide, Creatinine and Blood urea nitrogen became normal levels at day 1,4 and 11 of post-operation respectively, The concentration of blood glucose was stabilized gradually to normal level and therefore the injected insulin was stopped using to the patient at day 16 of post-operative days. OGTT test showed the function of grafted pancreas was normal 3 weeks after transplant, and no transplantation-related complications occurred. With the recipient followed up for 6 months, both his blood glucose level and renal function maintained normal without using injected insulin, and he was getting to recover from other diabetic complications also,

关 键 词：胰肾联合移植 糖尿病 终末期肾病 

分 类 号：R657.5[医药卫生—外科学] R699.2[医药卫生—临床医学]