Present status of pancreas transplantation in Japan-donation predominantly from marginal donors and modified surgical technique: Report of Japan pancreas transplantation registry

被引：28

作者：

Ishibashi, M. ^{[1
]}

Ito, T. ^{[2
]}

Sugitani, A. ^{[3
]}

Furukawa, H. ^{[4
]}

Sekiguchi, S. ^{[5
]}

Gotoh, M. ^{[6
]}

Teraoka, S. ^{[7
]}

Sato, Y. ^{[8
]}

Matsuno, N. ^{[9
]}

Kenmochi, S. ^{[10
]}

Uchida, H.

Yoshimura, N. ^{[11
]}

Nakajima, Y. ^{[12
]}

Kuroda, Y. ^{[13
]}

Odan, H. ^{[14
]}

Idezuki, Y.

Kanazawa, Y.

机构：

[1] Nara Med Univ, Dept Urol, Nara 6348522, Japan

[2] Osaka Univ Hosp, Dept Surg, Osaka 553, Japan

[3] Kyushu Univ Hosp, Dept Surg & Oncol, Fukuoka 812, Japan

[4] Hokkaido Univ Hosp, Dept Surg & Transplantat 1, Sapporo, Hokkaido 060, Japan

[5] Tohoku Univ Hosp, Dept Surg, Sendai, Miyagi, Japan

[6] Fukushima Med Univ Hosp, Dept Surg 1, Fukushima, Japan

[7] Tokyo Womens Med Univ Hosp, Dept Surg 3, Tokyo, Japan

[8] Niigata Univ Hosp, Dept Surg 1, Niigata, Japan

[9] Tokyo Med Univ Hachioji Hosp, Dept Surg, Tokyo, Japan

[10] Natl Chiba Higashi Hosp, Dept Surg, Chiba, Japan

[11] Nagoya Daini Red Cross Hosp, Dept Transplantat Surg, Nagoya, Aichi, Japan

[12] Nara Med Univ Hosp, Dept Surg 1, Nara, Japan

[13] Kobe Univ Hosp, Dept Surg, Kobe, Hyogo, Japan

[14] Hiroshma Univ Hosp, Dept Surg, Hiroshima, Japan

来源：

TRANSPLANTATION PROCEEDINGS | 2008年 / 40卷 / 02期

关键词：

D O I：

10.1016/j.transproceed.2008.01.047

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 [免疫学];

摘要：

In Japan, organ donation has been still limited because of the strict donor criteria. The aim of this study was to show the effectiveness of pancreas transplantation (PTx) by analyzing the outcomes even under poor donor conditions. Thirty-six cases of PTx (32 simultaneous pancreas and kidney transplantations [SPK], 4 pancreas after kidney transplantations) performed during the last 8 years were examined especially for donor characteristics. Mean donor age of 41.4 +/- 11.9 years was considerably older compared with that in the United States and Europe; donors aged over 40 years comprised 67% of the total. According to the criteria described by Kapur, 29 cases (81%) in our series would be considered marginal. Thus, to increase blood supply into the pancreatic head, the gastroduodenal artery (GDA) was anastomosed using donor artery to common hepatic artery or iliac Y graft. These procedures were performed in 16 of the 24 cases in which there was liver procurement. Eventually, 34 cases (94%) preserved GDA continuity. Mean total cold ischemic time of pancreatic grafts was 12 hours 1.5 minutes. Of 214 registrants, 17 patients on the waiting list for SPK died of diabetic complications. To date, patient survival remains 100% with a mean follow-up period of 33 months. Pancreas graft survivals at 1, 3, and 5 years posttransplantation were 92%, 80%, and 80%, respectively. In contrast, kidney survivals were 91%, 91%, and 91%, respectively. The integrity of the pancreas head and duodenum by preservation of the GDA continuity might have decreased the risk associated with the marginal donors.

引用

页码：486 / 490

页数：5

共 9 条

[1]

Amer Diabet Assoc, 2006, DIABETES CARE, V29, P935

[2]

Kidney and pancreas transplantation in the United States, 1996-2005 [J].