同时进行上腺和胰腺-脏移植以及相关的荷尔蒙挑战
Fabian Rössler1, Olivier De Rougemont1, Thomas Schachtner2
1Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
Swiss medical weekly
|October 14, 2025
概括
同时的胰腺-脏和上腺移植在技术上是安全的. 然而,术后内分泌管理和评估上腺移植功能仍然具有挑战性,需要专门的多学科护理.
科学领域:
- 内分泌学 在内分泌学.
- 移植手术 移植手术
- 免疫学 免疫学 免疫学
背景情况:
- 上腺移植很少进行,其功能结果可变.
- 有限证据表明内分泌管理和激素替代疗法在移植后逐渐减少.
- 自免疫性上腺功能衰竭需要仔细的内分泌监测.
研究的目的:
- 报告一次同时进行的胰腺-脏和上腺全移植.
- 评估移植后内分泌管理的可行性和挑战.
- 评估上腺移植功能和类固醇逐渐减少的协议.
主要方法:
- 一个单一的病例报告,一名48岁的女性患者同时接受了胰腺-脏和上腺全移植.
- 监测胰腺,脏和上腺移植的功能.
- 评估类固醇逐渐减少和激素替代疗法.
主要成果:
- 手术在技术上是安全的,胰腺和脏移植功能很好.
- 上腺移植功能很难评估,而类固醇逐渐减小的耐受性很差.
- 持续的上腺移植功能没有实现,需要持续的激素替代疗法.
结论:
- 同时的胰腺-脏和上腺移植在技术上是可行的和安全的.
- 术后内分泌管理,包括类固醇缩小和移植功能评估,存在重大挑战.
- 终身免疫抑制仅在与脏或胰腺脏移植相结合时是合理的,需要跨学科的患者随访.
相关概念视频
Kidney Transplant II: Surgical Procedure
307
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
307
Kidney Transplant I: Introduction
340
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
340
Kidney Transplant III: Nursing Management
317
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
317
Adrenal Gland Disorders
2.9K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
2.9K
Chronic Pancreatitis II: Collaborative Care
311
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
311
Anatomy of the Adrenal Glands
4.3K
The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
4.3K


