• 浙江醫(yī)科大學(xué)附屬第一醫(yī)院肝膽胰外科，衛(wèi)生部多器官聯(lián)合移植重點(diǎn)研究實(shí)驗(yàn)室（杭州310003）;

胰腺移植主要包括單獨(dú)胰腺移植（pancreas transplantation alone, PTA）、腎移植后胰腺移植（pancreas after kidney transplantation, PAK）和胰腎聯(lián)合移植（simultaneous pancreaskidney transplantation, SPK）。與其它實(shí)體大器官移植一樣，胰腺移植成功的真正轉(zhuǎn)折始于20世紀(jì)70年代末。隨著新型免疫抑制劑的開發(fā)和應(yīng)用、器官保存技術(shù)的改進(jìn)和外科技術(shù)的日臻成熟，胰腺移植在全球范圍內(nèi)得到迅猛開展，胰腺移植受體及器官存活率顯著提高。據(jù)國際胰腺移植登記中心（International Pancreas Transplant Registry, IPTR）記錄，至2001年10月，全球已實(shí)施17 000余例胰腺移植，其中美國有11 500余例，胰腺移植后患者1年生存率超過95%，3年生存率接近90%； 移植胰腺1年和3年有功能生存率分別為83%和77%［1，2］。自1966年首例SPK在美國Minnesota大學(xué)成功實(shí)施以來，SPK已成為治療Ⅰ型糖尿病合并腎功能衰竭的常規(guī)方法，全世界迄今為止已實(shí)施的胰腺移植中約90%采用該術(shù)式［3，4］。

引用本文： 鄭樹森,徐驍. 當(dāng)今胰腺移植的重大進(jìn)展與前景. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(3): 201-203. doi: 復(fù)制

1. Gruessner AC, Sutherland DE. Analysis of United States (US) and nonUS pancreas transplants reported to the united network for organ sharing (UNOS) and the international pancreas transplant registry (IPTR) as of October 2001 [J]. Clin Transpl, 2001; 15(1)∶41.
2. Kahl A, Bechstein WO, Frei U. Trends and perspectives in pancreas and simultaneous pancreas and kidney transplantation [J]. Curr Opin Urol, 2001; 11(2)∶165.
3. Kelly WD, Lillehei RC, Merkel FK, et al. Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy [J]. Surgery, 1967; 61(6)∶827.
4. Sutherland DE, Gruessner RW, Dunn DL, et al. Lessons learned from more than 1,000 pancreas transplants at a single institution [J]. Ann Surg, 2001; 233(4)∶463.
5. Sollinger HW, Odorico JS, Knechtle SJ, et al. Experience with 500 simultaneous pancreaskidney transplants [J]. Ann Surg, 1998; 228(3)∶284.
6. Becker BN, Odorico JS, Becker YT, et al. Simultaneous pancreaskidney and pancreas transplantation [J]. J Am Soc Nephrol, 2001; 12(11)∶2517.
7. Cook K, Sollinger HW, Warner T, et al. Pancreaticocystostomy: an alternative method for exocrine drainage of segmental pancreatic allografts [J]. Transplantation, 1983; 35(6)∶634.
8. Stratta RJ, Larsen JL, Cushing K. Pancreas transplantation for diabetes mellitus [J]. Annu Rev Med, 1995; 46∶281.
9. Rosenlof LK, Earnhardt RC, Pruett TL, et al. Pancreas transplantation. An initial experience with systemic and portal drainage of pancreatic allografts [J]. Ann Surg, 1992; 215(6) ∶586.
10. Gaber AO, ShokouhAmiri H, Grewal HP, et al. A technique for portal pancreatic transplantation with enteric drainage [J]. Surg Gynecol Obstet, 1993; 177（4）∶417.
11. Stratta RJ, Gaber AO, ShokouhAmiri MH, et al. A prospective comparison of systemicbladder versus portalenteric drainage in vascularized pancreas transplantation [J]. Surgery, 2000; 127（2）∶217.
12. Petruzzo P, Da Silva M, Feitosa LC, et al. Simultaneous pancreaskidney transplantation: portal versus systemic venous drainage of the pancreas allografts [J]. Clin Transplant, 2000; 14(4 Pt 1)∶287.
13. Philosophe B, Farney AC, Schweitzer EJ, et al. Superiority of portal venous drainage over systemic venous drainage in pancreas transplantation: a retrospective study [J]. Ann Surg, 2001; 234(5)∶689.
14. Reddy KS,Stratta RJ,ShokouhAmiri H,et al. Simultaneous kidneypancreas transplantation without antilymphocyte induction [J]. Transplantation, 2000; 69(1)∶49.
15. Stratta RJ, Alloway RR, Hodge E, et al. A multicenter, openabel, comparative trial of two daclizumab dosing strategies vs. no antibody induction in combination with tacrolimus, mycophenolate mofetil, and steroids for the prevention of acute rejection in simultaneous kidneypancreas transplant recipients: interim analysis [J]. Clin Transplant, 2002; 16(1)∶60.
16. Hesse UJ, Troisi R, Jacobs B, et al. A single center’s clinical experience with quadruple immunosuppression including ATG or IL2 antibodies and mycophenolate mofetil in simultaneous pancreaskidney transplants [J]. Clin Transplant, 2000; 14(4 Pt 1)∶340.
17. Kaufman DB,Leventhal JR,Koffron AJ,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 [J]. Transplantation, 2002; 73(2)∶169.
18. Douzdjian V, Escobar F, Kupin WL, et al. Costutility analysis of livingdonor kidney transplantation followed by pancreas transplantation versus simultaneous pancreaskidney transplantation [J]. Clin Transplant, 1999; 13(1 Pt 1)∶51.
19. Gruessner RW, Sutherland DE. Living donor pancreas transplantation [J]. Transplantation Rev, 2002; 16(2) ∶108.
  1. 1. Gruessner AC, Sutherland DE. Analysis of United States (US) and nonUS pancreas transplants reported to the united network for organ sharing (UNOS) and the international pancreas transplant registry (IPTR) as of October 2001 [J]. Clin Transpl, 2001; 15(1)∶41.
  2. 2. Kahl A, Bechstein WO, Frei U. Trends and perspectives in pancreas and simultaneous pancreas and kidney transplantation [J]. Curr Opin Urol, 2001; 11(2)∶165.
  3. 3. Kelly WD, Lillehei RC, Merkel FK, et al. Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy [J]. Surgery, 1967; 61(6)∶827.
  4. 4. Sutherland DE, Gruessner RW, Dunn DL, et al. Lessons learned from more than 1,000 pancreas transplants at a single institution [J]. Ann Surg, 2001; 233(4)∶463.
  5. 5. Sollinger HW, Odorico JS, Knechtle SJ, et al. Experience with 500 simultaneous pancreaskidney transplants [J]. Ann Surg, 1998; 228(3)∶284.
  6. 6. Becker BN, Odorico JS, Becker YT, et al. Simultaneous pancreaskidney and pancreas transplantation [J]. J Am Soc Nephrol, 2001; 12(11)∶2517.
  7. 7. Cook K, Sollinger HW, Warner T, et al. Pancreaticocystostomy: an alternative method for exocrine drainage of segmental pancreatic allografts [J]. Transplantation, 1983; 35(6)∶634.
  8. 8. Stratta RJ, Larsen JL, Cushing K. Pancreas transplantation for diabetes mellitus [J]. Annu Rev Med, 1995; 46∶281.
  9. 9. Rosenlof LK, Earnhardt RC, Pruett TL, et al. Pancreas transplantation. An initial experience with systemic and portal drainage of pancreatic allografts [J]. Ann Surg, 1992; 215(6) ∶586.
  10. 10. Gaber AO, ShokouhAmiri H, Grewal HP, et al. A technique for portal pancreatic transplantation with enteric drainage [J]. Surg Gynecol Obstet, 1993; 177（4）∶417.
  11. 11. Stratta RJ, Gaber AO, ShokouhAmiri MH, et al. A prospective comparison of systemicbladder versus portalenteric drainage in vascularized pancreas transplantation [J]. Surgery, 2000; 127（2）∶217.
  12. 12. Petruzzo P, Da Silva M, Feitosa LC, et al. Simultaneous pancreaskidney transplantation: portal versus systemic venous drainage of the pancreas allografts [J]. Clin Transplant, 2000; 14(4 Pt 1)∶287.
  13. 13. Philosophe B, Farney AC, Schweitzer EJ, et al. Superiority of portal venous drainage over systemic venous drainage in pancreas transplantation: a retrospective study [J]. Ann Surg, 2001; 234(5)∶689.
  14. 14. Reddy KS,Stratta RJ,ShokouhAmiri H,et al. Simultaneous kidneypancreas transplantation without antilymphocyte induction [J]. Transplantation, 2000; 69(1)∶49.
  15. 15. Stratta RJ, Alloway RR, Hodge E, et al. A multicenter, openabel, comparative trial of two daclizumab dosing strategies vs. no antibody induction in combination with tacrolimus, mycophenolate mofetil, and steroids for the prevention of acute rejection in simultaneous kidneypancreas transplant recipients: interim analysis [J]. Clin Transplant, 2002; 16(1)∶60.
  16. 16. Hesse UJ, Troisi R, Jacobs B, et al. A single center’s clinical experience with quadruple immunosuppression including ATG or IL2 antibodies and mycophenolate mofetil in simultaneous pancreaskidney transplants [J]. Clin Transplant, 2000; 14(4 Pt 1)∶340.
  17. 17. Kaufman DB,Leventhal JR,Koffron AJ,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 [J]. Transplantation, 2002; 73(2)∶169.
  18. 18. Douzdjian V, Escobar F, Kupin WL, et al. Costutility analysis of livingdonor kidney transplantation followed by pancreas transplantation versus simultaneous pancreaskidney transplantation [J]. Clin Transplant, 1999; 13(1 Pt 1)∶51.
  19. 19. Gruessner RW, Sutherland DE. Living donor pancreas transplantation [J]. Transplantation Rev, 2002; 16(2) ∶108.