单中心胰肾联合移植的远期疗效观察  

Long-term follow-up of simultaneous pancreas-kidney transplantation in a single center

作　　者：王洪良 黄晨 刘飞 乔鹏飞 刘越 蓝柳根[2] 吴基华[2] 董建辉 李美思 孙煦勇 Wang Hongliang;Huang Chen;Liu Fei;Qiao Pengfei;Liu yue;Lan Liugen;Wu Jihua;Dong Jianhui;Li Meisi;Sun Xuyong(Department of Organ Transplantation,923th Hospital of PLA Joint Logistic Support Force,Nanning 530000,Guangxi,China;Transplant Medical Center of The Second Affiliated Hospital of Guangxi Medical University,Guangxi Clinical Research Center for Organ Transplantation,Guangxi Key Laboratory of Organ Donation and Transplantation,Nanning 530000,Guangxi,China.)

机构地区：[1]中国人民解放军联勤保障部队第九二三医院器官移植科,广西南宁530000 [2]广西医科大学第二附属医院移植医学中心,广西器官移植临床医学研究中心,广西器官捐献与移植研究重点实验室,广西南宁530007

出　　处：《实用器官移植电子杂志》2023年第6期509-513,共5页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：广西科学研究与技术开发计划项目(桂科攻14124003-8);广西壮族自治区卫生健康委自筹经费课题(Z-A20231058,Z20201255)。

摘　　要：目的回顾性分析单中心58例胰肾联合移植的远期疗效及相关影响因素。方法回顾性分析中国人民解放军联勤保障部队第九二三医院器官移植科2010年5月至2019年12月完成的58例胰肾联合移植手术受者和移植器官的存活率,并分析移植器官功能丢失和受者死亡原因。结果1、3、5、8年受者生存率分别为98.28%、98.28%、92.24%、89.99%,移植胰腺存活率分别为86.21%、84.48%、78.40%、76.16%,移植肾存活率分别为98.28%、98.28%、82.83%、80.60%,胰液膀胱引流(bladder drainage,BD)术式1、3、5、8年生存率为96.15%、96.15%、86.73%、86.73%,胰液空肠引流(enteric drainage,ED)术式1、3、5、8年生存率为100%、100%、96.67%、93.33%(P=0.187)。结论胰肾联合移植对于终末期糖尿病肾病的远期疗效较好,ED术式可能会有更好的长期预后,外科并发症是影响胰肾联合移植远期疗效的主要因素,器官排斥反应、感染和受者带功死亡也是移植器官功能丢失的重要因素。Objective To analyze the long-term results after simultaneous pancreas-kidney transplantation at a single center.Methods A retrospective analysis of the survival rates of 58 recipients and transplanted organs from May 2010 to December 2019 was conducted in the Department of Organ Transplantation,923th Hospital of PLA Joint Logistic Support Force.The causes of death and loss of graft function were analyzed.Results Recipient's survival rates in the 1,3,5 and 8 years were 98.28%,98.28%,92.24% and 89.99%,respectively.The 1,3,5 and 8 year survival rates of pancreas grafts were 86.21%,84.48%,78.40% and 76.16%,and that of kidney grafts were 98.28%,98.28%,82.83% and 80.60%,respectively.The survival rates after bladder drainage(BD) procedure at 1,3,5 and 8 year was 96.15%、96.15%、86.73% and 86.73% and the survival rates of enteric drainage(ED) procedure was 100%,100%,96.67% and 93.33%(P = 0.187).Conclusion Simultaneous pancreas-kidney transplantation has a good long-term effect on end-stage diabetic nephropathy.Surgical complications are the main factors affecting the long-term outcomes.ED procedure may have a better long-term prognosis.Infection,rejection and recipient death are also important factors for graft function loss.

关 键 词：糖尿病 终末期肾病 肾移植 胰腺移植 胰肾联合移植 

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