胰腺移植后糖尿病患者的存活率和保存功能
Jeffrey M Venstrom1, Maureen A McBride, Kristina I Rother
1Transplantation and Autoimmunity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Md 20892, USA.
JAMA
|December 6, 2003
概括
单独的胰腺移植 (单独的胰腺或胰腺后的脏) 显示糖尿病患者和良好的功能患者的生存率比传统治疗更差. 这项研究强调了与这些特定的胰腺移植手术相关的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 内分泌学 在内分泌学.
背景情况:
- 单独的胰腺移植治疗糖尿病是有争议的,因为风险和未经证实的好处.
- 胰腺移植对糖尿病常规疗法的生存优势尚不清楚.
研究的目的:
- 评估单一胰腺移植与患者存活率之间的关联.
- 为了比较糖尿病患者的存活率,保留功能,接受单一胰腺移植,与等待名单上的患者相比.
主要方法:
- 一项回顾性观察队列研究分析了来自美国器官共享/器官采购和移植网络 (1995-2000) 的11572名糖尿病患者.
- 接受单独胰腺移植 (单独胰腺或胰腺-脏) 的患者,脏功能得到保护,与类似的等待名单患者进行了比较.
- 排除标准包括多器官移植和肌素> 2 mg/dL的患者或同时接受胰腺脏移植的患者.
主要成果:
- 与等候名单患者相比,单独胰腺移植与4年内全因死亡的相对风险更高.
- 脏移植后的胰腺显示出统计学上显著的死亡风险增加 (RR,1.42;P =.03).
- 与等待名单患者相比,仅胰腺移植 (85.2%) 和胰腺移植后脏 (84.5%) 的患者的四年生存率较低 (分别为92.1%和88.1%).
结论:
- 从1995年至2000年,糖尿病患者的单独胰腺移植与保存功能有关,与明显更糟糕的生存率有关.
- 接受常规治疗的等待名单患者表现出比接受单一胰腺移植的患者更好的生存结果.
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