胰肾联合移植15年以上存活者生活质量及移植器官功能评估  

Evaluations of qulity-of-life and organ functions in patients with pancreas kidney transplantation over 15 years

作　　者：陈旭春[1] 刘树荣[1] 李弘[1] 成东华[1] 程颖[1] 刘永锋[1] Chen Xuchun;Liu Shurong;Li Hong;Cheng Donghua;Cheng Ying;Liu Yong feng(Depurtment of Organ Transplantation.The First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院器官移植科,沈阳110001

出　　处：《中华器官移植杂志》2020年第9期530-533,共4页Chinese Journal of Organ Transplantation

摘　　要：目的探讨2型糖尿病肾病尿毒症期行胰肾联合移植术后存活期超过15年受者生活质量及器官功能状态。方法回顾分析中国医科大学附属第一医院2000年至2005年因2型糖尿病肾病尿毒症期行胰肾联合移植术后随访至今(2017年失访1例)存活期超过15年的4例受者的资料,评估:移植胰腺、移植肾功能,对生活质量及并发症进行分析。结果4例受者原发病均为2型糖尿病肾病。手术方式均为同期胰肾联合移植(膀胱引流式)。受者在随访过程中生活质量良好。4例受者中3例肾功能和空腹血糖,C肽检查均正常,1例d清肌酐和空腹血糖轻度升高。1例术后15年发生淋巴瘤,1例术后14年出现切口疝行痛修补术。1例术后出现3次血尿。结论2型糖尿病肾病尿毒症期行胰肾联合移植术,移植胰腺及肾功能稳定,术后因免疫抑制引起的恶性肿瘤仍然需密切注意。Objective To explore the long term outcomes of patients with type 2 diabetes mellitus(T2DM)and end-stage renal disease(ESRD)after simultaneous pancreas kidney(SPK)transplantation.Methods The clinical data were analyzed retrospectively for 4 patients with T2DM and ESRD surviving over 15 years after SPK transplantation.Results All of them survived for over 15 years.T ransplantation was performed with a standard approach via a drainage of exocrine secretion into bladder and a diversion of venous outflow into systemic circulation.During a follow up period of over 15 years,blood glucose,C peptide and serum creatinine levels of 3/4 patients remained normal and stable.Serum creatinine and blood glucose slightly increased in 1 patient at 11 years post SPK.One patient had lymphoma at 15 years after operation.Incisional hernia occurred at 14 years after operation in 1 patient and hernioplasty was performed.One patient had the symptoms of multiple hematuria.Conclusions SPK transplantation can achieve a stable long term efficacy over 15 years in patients with T2DM and ESRD.Postoperative malignant tumors require close monitoring.

关 键 词：胰肾联合移植 糖尿病 并发症 

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