Solid pancreas transplant: Pushing forward

查看全文 作　　者：Emmanouil [1,2]Giorgakis;Amit K [1]Mathur;Harini A [3]Chakkera;Kunam S [1]Reddy;Adyr A [1]Moss;Andrew L [1]Singer 机构地区：[1]Division of Transplant, Department of Surgery, Mayo Clinic;[2]Department of Transplant, University of Arkansas for Medical Sciences;[3]Division of Nephrology, Department of Internal Medicine, Mayo Clinic 出　　处：《World Journal of Transplantation》索引2018年第8卷第7期,共15页 摘　　要：Pancreas transplant has evolved significantly in recent years. It has now become a viable treatment option on type 1 diabetic patients with poorly controlled diabetes on conventional treatment, insulin intolerance, hypoglycaemia unawareness, brittle diabetes and/or end-stage kidney disease. The purpose of this review is to provide an overview of pancreas transplant historical origins and current barriers to broader utilization of pancreata for transplant, with a focus on areas for future improvement to better pancreas transplant care. Donor pancreata remain underutilized; pancreatic allograft discard rates remain close to 30% in the United States. Donations after cardiac death(DCD) pancreata are seldom procured. Study groups from Europe and the United Kingdom showed that procurement professionalization and standardization of technique, as well as development of independent regional procurement teams might increase organ procurement efficiency, decrease discards and increase pancreatic allograft utilization. Pancreas transplant programs should consider exploring pancreas procurement opportunities on DCD and obese donors. Selected type 2 diabetics should be considered for pancreas transplant. Longer follow-up studies need to be performed in order to ascertain the long-term cardiovascular and quality of life benefits following pancreas transplant; the outcomes of which might eventually spearhead advocacy towards broader application of pancreas transplant among diabetics. 关 键 词：PANCREAS TRANSPLANT WHOLE PANCREAS TRANSPLANT Donations after cardiac death PANCREAS TRANSPLANT OBESE PANCREAS DONORS PANCREAS TRANSPLANT for type 2 diabetes