摘要
背景:胰肾联合移植是治疗终末期糖尿病肾病的主要方法,供胰的质量直接关系到受者的手术安全及长期存活,但是国内目前对于胰肾联合移植供胰评估标准并无统一规范。目的:总结分析63例脑死亡器官捐献供者供胰的评估标准。方法:回顾性分析2016年9月至2018年11月广州医科大学附属第二医院完成脑死亡器官捐献潜在供胰的评估、获取及胰肾联合移植的临床资料。供胰和供肾来源于器官获取组织主导的公民器官捐献,脑死亡供者根据《中国脑死亡判定标准(成人)》进行判定。通过胰肾联合移植供胰评估的主要标准、次要标准和禁忌证,对供者进行严格评估和筛选。结果与结论:对168例供者进行严格评估,共成功完成63例胰肾联合移植供胰的评估、获取和手术,供胰的冷缺血时间为145-320 min。手术方法均采用改良的同侧胰肾联合移植术。63例患者手术过程顺利,1例受者术后需口服降糖药,1例受者恢复胰岛素使用,余受者血糖正常,均成功摆脱降糖药和胰岛素,取得了良好的手术效果。结果表明,采用作者所在移植中心胰肾联合移植前供胰评估标准,可以简单有效地进行供胰评估,提高了供胰利用率,并取得了良好的手术效果。
BACKGROUND:Simultaneous pancreas-kidney transplantation is the main method for the treatment of end-stage diabetic nephropathy.The quality of donor pancreas is directly related to the surgical safety and long-term survival of the recipient.However,there is yet no unified standard for the evaluation of pancreatic-kidney transplantation in China.OBJECTIVE:To summarize the assessment criteria of donor pancreas transplants base on 63 cases of donation after brain death.METHODS:From September 2016 to November 2018,clinical data of potential pancreas donors after brain death,donor acquisition,and simultaneous pancreas-kidney transplantation were evaluated in the Second Affiliated Hospital of Guangzhou Medical University in China.Pancreas and kidney transplants were from organ donation launched by organ procurement organizations,and the diagnoses of brain death were based on the Criteria for Determination of Brain Death in Adults.We rigorously evaluated and screened potential donors based on the pancreas donor criteria for simultaneous pancreas-kidney transplantation.RESULTS AND CONCLUSION:A total of 168 potential pancreas donors after brain death were subjected to rigorous assessment and 63 donor pancreas transplants for simultaneous pancreas-kidney transplantation were successfully obtained.The time for cold ischemia was 145-320 minutes.Sixty-three transplant recipients were all operated with the ipsilateral simultaneous pancreas-kidney transplantation.The operation was successful in all the 63 patients.One patient needed to take oral antihyperglycemic drugs,and one patient had a demand for insulin therapy to control the blood glucose level in normal range.The levels of blood glucose in the other patients were normal with no need of oral antidiabetic drugs and insulin,and the outcome of treatment was satisfactory.To conclude,we provide a simple but effective way to assess pancreas allograft quality,improve the utilization of donor pancreas,and achieve favorable operation outcomes.
作者
刘路浩
方佳丽
张磊
李光辉
徐璐
赖兴强
熊韫祎
陈荣鑫
马俊杰
陈正
Liu Luhao;Fang Jiali;Zhang Lei;Li Guanghui;Xu Lu;Lai Xingqiang;Xiong Yunyi;Chen Rongxin;Ma Junjie;Chen Zheng(Department of Organ Transplantation,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第26期4157-4161,共5页
Chinese Journal of Tissue Engineering Research
基金
广医二院博士启动项目(52010202-1001),项目负责人:刘路浩。
关键词
器官捐献
脑死亡器官捐献
胰肾联合移植
胰腺移植
供胰评估标准
organ donation
donation after brain death
simultaneous pancreas-kidney transplantation
pancreas transplantation
donor pancreas assessment criteria
