Pancreatic transplantation: Beta cell replacement

被引:2
作者
Bigam D.L. [1 ]
Shapiro A.M.J. [1 ]
机构
[1] University of Alberta Hospital, Edmonton, Alta. T6G 287
关键词
Tacrolimus; Chronic Pancreatitis; Sirolimus; Main Drug Interaction; Islet Transplantation;
D O I
10.1007/s11938-004-0046-9
中图分类号
学科分类号
摘要
Diabetes is a leading cause of morbidity and mortality worldwide. Complications of diabetes including renal failure, retinopathy, neuropathy, and cardiovascular disease limit both survival and quality of life. Pancreatic transplantation can restore euglycemia thereby stabilizing or even reversing secondary complications of diabetes as well as improving quality of life particularly in patients with labile diabetes. Recent evidence also shows an improved survival in diabetic patients that undergo pancreatic transplantation when combined with a kidney transplant. Pancreatic transplantation should more properly be referred to as beta cell replacement as the field today encompasses both whole organ and islet cell transplantation. We have outlined herein the indications and contraindications to islet or whole organ pancreas transplantation and we have described periprocedure care and short- and long-term prognosis. Copyright © 2004 by Current Science Inc.
引用
收藏
页码:329 / 341
页数:12
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共 35 条
  • [1] The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus, N. Engl. J. Med., 329, pp. 977-986, (1993)
  • [2] Stratta R.J., Lo A., Shokouh-Amiri M.H., Et al., Improving results in solitary pancreas transplantation with portal-enteric drainage, thymoglobin induction, and tacrolimus/mycophenolate mofetil-based immunosuppression, Transpl. Int., 16, pp. 154-160, (2003)
  • [3] Kaufman D.B., Burke G.W., Bruce D.S., Et al., Prospective, randomized, multi-center trial of antibody induction therapy in simultaneous pancreas-kidney transplantation, Am. J. Transplant., 3, pp. 855-864, (2003)
  • [4] Tan M., Cantarovich M., Mangel R., Et al., Reduced dose Thymoglobulin, tacrolimus, and mofetil mycophenolate results in excellent solitary pancreas transplantation outcomes, Clin. Transplant., 16, pp. 414-418, (2002)
  • [5] Kaufman D.B., Leventhal J.R., Koffrom A.J., Et al., A prospective study of rapid corticosteroid elimination in simultaneous pancreas-kidney transplantation: Comparison of two maintenance immunosuppression protocols: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus, Transplantation, 73, pp. 169-177, (2002)
  • [6] Freise C.E., Kang S.-M., Feng S., Et al., Excellent short-term results with steroid-free maintenance immunosuppression in low-risk simultaneous pancreas-kidney transplantation, Arch. Surg., 138, pp. 1121-1125, (2003)
  • [7] Akalin E., Sehgal V., Ames S., Et al., Cytomegalovirus disease in high-risk transplant recipients despite ganciclovir or valganciclovir prophylaxis, Am. J. Transplant., 3, pp. 731-735, (2003)
  • [8] Trofe J., Gaber L.W., Stratta R.J., Et al., Polyomavirus in kidney and kidney-pancreas transplant recipients, Transpl. Infect. Dis., 5, pp. 21-28, (2003)
  • [9] Drachenberg C.B., Rlassen D.K., Weir M.R., Et al., Islet cell damage associated with tacrolimus and cydosporine: Morphological features in pancreas allograft biopsies and clinical correlation, Transplantation, 68, pp. 396-402, (1999)
  • [10] Reddy K.S., Davies D., Ormond D., Et al., Impact of acute rejection episodes on long-term graft survival following simultaneous kidney-pancreas transplantation, Am. J. Transplant., 3, pp. 439-444, (2003)