Pancreas transplantation in the United States: a review

被引：97
作者：
Gruessner, Angelika C. [1 ,2 ]
Sutherland, David E. R. [3 ]
Gruessner, Rainer W. G. [2 ]
机构：
[1] Univ Arizona, MEZCOPH, Epi Biostats Div, Tucson, AZ 85724 USA
[2] Univ Arizona, Dept Surg, Tucson, AZ 85724 USA
[3] Univ Minnesota, Dept Surg, Minneapolis, MN 55455 USA
来源：
CURRENT OPINION IN ORGAN TRANSPLANTATION | 2010年 / 15卷 / 01期
关键词：
graft function; immunologic graft loss; pancreas transplantation; patient survival; TYPE-1; DIABETIC-PATIENTS; KIDNEY TRANSPLANTATION; PATIENT SURVIVAL; DONOR; RECIPIENTS; EUROTRANSPLANT; ALLOGRAFT; MORTALITY; IMPACT;
D O I：
10.1097/MOT.0b013e32833552d2
中图分类号：
R3 [基础医学]; R4 [临床医学];
学科分类号：
1001 ; 1002 ; 100602 ;
摘要：
Purpose of review The goal of pancreas transplantation is to restore normoglycemia in patients with labile diabetes. The results of this procedure improved over the years, but, although pancreas transplantation is not considered experimental anymore, there is often reluctance to recommend this procedure because of the complexity, especially for solitary pancreas transplants. This article reviews the current status of pancreas transplantation. Recent findings Many improvements have been made in the surgical techniques and immunosuppressive regimens. The overall rate of technical problems decreased, yet immunologic graft loss is still a problem in solitary pancreas transplants. Careful donor selection significantly decreased the risk of graft failure and therefore improved patient survival. Summary With modern immunosuppressive protocols and careful donor selection, patient survival rates and pancreas transplant graft function can be further improved in all three pancreas transplant categories.
引用
收藏
页码：93 / 101
页数：9
相关论文
共 21 条
[1]   Outcome of Pancreas Transplantation in Recipients Older Than 50 Years: A Single-Centre Experience [J].
Ablorsu, Elijah ;
Ghazanfar, Abbas ;
Mehra, Sanjay ;
Campbell, Babatunde ;
Riad, Hany ;
Pararajasingam, Ravi ;
Parrott, Neil ;
Picton, Michael ;
Augustine, Titus ;
Tavakoli, Afshin .
TRANSPLANTATION, 2008, 86 (11) :1511-1514
[2]   Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease [J].
Becker, BN ;
Brazy, PC ;
Becker, YT ;
Odorico, JS ;
Pintar, TJ ;
Collins, BH ;
Pirsch, JD ;
Leverson, GE ;
Heisey, DM ;
Sollinger, HW .
KIDNEY INTERNATIONAL, 2000, 57 (05) :2129-2135
[3]   Progression of macrovascular diseases is reduced in type 1 diabetic patients after more than 5 years successful combined pancreas-kidney transplantation in comparison to kidney transplantation alone [J].
Biesenbach, G ;
Königsrainer, A ;
Gross, C ;
Margreiter, R .
TRANSPLANT INTERNATIONAL, 2005, 18 (09) :1054-1060
[4]   Kidney allograft and patient survival in type I diabetic recipients of cadaveric kidney alone versus simultaneous pancreas/kidney transplants:: A multivariate analysis of the UNOS database [J].
Bunnapradist, S ;
Cho, YW ;
Cecka, JM ;
Wilkinson, A ;
Danovitch, GM .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (01) :208-213
[5]  
Gruessner Angelika C, 2008, Clin Transpl, P45
[6]   Mortality assessment for pancreas transplants [J].
Gruessner, RWG ;
Sutherland, DER ;
Gruessner, AC .
AMERICAN JOURNAL OF TRANSPLANTATION, 2004, 4 (12) :2018-2026
[7]   Pancreas after living donor kidney transplants in diabetic patients: impact on long-term kidney graft function [J].
Kleinclauss, Francois ;
Fauda, Martin ;
Sutherland, David E. R. ;
Kleinclauss, Colette ;
Gruessner, Rainer W. ;
Matas, Arthur J. ;
Kasiske, Bertram L. ;
Humar, Abhinav ;
Kandaswamy, Raja ;
Kaul, Suruchi ;
Gruessner, Angelika C. .
CLINICAL TRANSPLANTATION, 2009, 23 (04) :437-446
[8]   Minimization and withdrawal of steroids in pancreas and islet transplantation [J].
Mineo, Davide ;
Sageshima, Junichiro ;
Burke, George W. ;
Ricordi, Camillo .
TRANSPLANT INTERNATIONAL, 2009, 22 (01) :20-37
[9]   Metabolic Control Improves Long-Term Renal Allograft and Patient Survival in Type 1 Diabetes [J].
Morath, Christian ;
Zeier, Martin ;
Doehler, Bernd ;
Schmidt, Jan ;
Nawroth, Peter P. ;
Opelz, Gerhard .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2008, 19 (08) :1557-1563
[10]   Alemtuzumab induction and steroid-free maintenance immunosuppression in pancreas transplantation [J].
Muthusamy, A. S. R. ;
Vaidya, A. C. ;
Sinha, S. ;
Roy, D. ;
Elker, D. E. ;
Friend, P. J. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2008, 8 (10) :2126-2131
123