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肝胰联合移植
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     We study observed the mutual benefits of pancreas and liver in combined hepaticopancreatic transplantation in rats.
     作者为观察肝脏对胰腺的免疫保护作用和胰腺对肝脏的营养保护作用,采用大鼠单独胰腺移植、单独肝脏移植及肝胰联合移植进行研究。
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     Methods From October 2001 to January 2005, 19 patients received multiorgan transplantation in Nanfang Hospital, including 6 with simultaneous kidney-pancreas transplantation (SKPT), 12 with combined liver-kidney transplantation (CLKT), and 1 with simultaneous liver-pancreas transplantation (SLPT).
     方法我院自2001年10月至2005年1月共施行19例腹部多器官联合移植术,其中胰肾联合移植6例、肝肾联合移植12例、肝胰联合移植1例;
短句来源
     Objective To study the effect of combined transplantation of the liver and the pancreas in diabetic patients withend-stage liver disease, and explore the optimal surgical procedure.
     目的评价肝胰联合移植治疗终末期肝病合并糖尿病的效果,探讨其最佳术式。
短句来源
     Conclusion End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreastransplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitutethe optimal surgical approaches as the primary choice.
     结论1、终末期肝病合并糖尿病,特别是需要胰岛素治疗的糖尿病,是肝胰联合移植的适应证; 2、同期原位肝-异位胰十二指肠联合移植优于其他肝胰联合移植术式,可以作为肝胰联合移植的常规首选术式。
短句来源
     In the SLPT patient, insulin was withdrawn 5 days after operation, liver allograft function recovered well.
     肝胰联合移植患者术后第5天停用胰岛素,移植肝功能恢复正常。
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     The lobulation is not so distinct in the liver and pancreas.
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  combined liver and pancreas transplantation
The possibility of combined liver and pancreas transplantation in these patients should be cautiously discussed on an individual basis.
      


We study observed the mutual benefits of pancreas and liver in combined hepaticopancreatic transplantation in rats. The result indicated that pancreas, when transplanted with liver, could survive for a significantly longer time(134±101 days) than it transplanted alone(92±114 days) (P<005). The interstitial rejection was mild and its rejection grade was significantly different from that of pancreas transplanted alone(P<005,χ2 test). The liver, when transplanted with pancreas, regenerated with strong...

We study observed the mutual benefits of pancreas and liver in combined hepaticopancreatic transplantation in rats. The result indicated that pancreas, when transplanted with liver, could survive for a significantly longer time(134±101 days) than it transplanted alone(92±114 days) (P<005). The interstitial rejection was mild and its rejection grade was significantly different from that of pancreas transplanted alone(P<005,χ2 test). The liver, when transplanted with pancreas, regenerated with strong competence and contact structure morphologically compared with liver transplanted alone. We concluded that pancreas could be immunologically protected against rejection and liver can be nutritionalized by pancreas in combined pancreas and liver transplantation.

作者为观察肝脏对胰腺的免疫保护作用和胰腺对肝脏的营养保护作用,采用大鼠单独胰腺移植、单独肝脏移植及肝胰联合移植进行研究。结果显示:胰腺联合肝脏移植时,胰腺平均功能存活期(13.1±1.01天)较单独移植(9.2±1.14天)时显著延长(P<0.05,t检验),间质排斥反应减轻,分级分布与单独移植相比差异有显著意义(P<0.05,);肝脏在联合移植时,术后再生能力以及形态的完整性优于单独移植。作者认为肝脏和胰腺联合移植时,肝脏能够得到胰腺提供的营养保护作用,胰腺也能得到肝脏的免疫保护作用。

Objective To study the effect of combined transplantation of the liver and the pancreas in diabetic patients withend-stage liver disease, and explore the optimal surgical procedure. Methods Simultaneous orthotopic liver and heterotopicpancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis,hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506),mycophenolate mofetil (MMF), and simulect....

Objective To study the effect of combined transplantation of the liver and the pancreas in diabetic patients withend-stage liver disease, and explore the optimal surgical procedure. Methods Simultaneous orthotopic liver and heterotopicpancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis,hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506),mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, andC-peptide were monitored after transplantation. Results Insulin was withdrawn at the 6th day after operation, good liverallograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections.Conclusion End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreastransplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitutethe optimal surgical approaches as the primary choice.

目的评价肝胰联合移植治疗终末期肝病合并糖尿病的效果,探讨其最佳术式。方法对1例慢性乙型病毒性肝炎、肝硬化、原发性肝细胞癌合并胰岛素依赖型糖尿病患者施行同期原位肝-异位胰十二指肠联合移植,术后早期采用皮质激素、霉酚酸酯、他克莫司、舒莱四联用药,监测肝功能、血淀粉酶、脂肪酶、血糖、胰岛素C肽变化及免疫指标。结果患者术后5 d后停用胰岛素,移植肝功能恢复正常,没有发生移植胰胰腺炎、血管栓赛、胰漏、局部感染等并发症。结论1、终末期肝病合并糖尿病,特别是需要胰岛素治疗的糖尿病,是肝胰联合移植的适应证;2、同期原位肝-异位胰十二指肠联合移植优于其他肝胰联合移植术式,可以作为肝胰联合移植的常规首选术式。

Objective To evaluate the clinical effect of abdominal multiorgan transplantation in patients with multiorgan failure. Methods Simultaneous kidney-pancreas transplantation (SKPT) with enteric drainage of pancreatic exocrine secretions was performed in 2 patients with type 1 diabetes and end-stage renal disease. A combined liver-kidney transplantation (CLKT) was done in a 66-year-old patient with alcoholic liver cirrhosis and uremia. Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation...

Objective To evaluate the clinical effect of abdominal multiorgan transplantation in patients with multiorgan failure. Methods Simultaneous kidney-pancreas transplantation (SKPT) with enteric drainage of pancreatic exocrine secretions was performed in 2 patients with type 1 diabetes and end-stage renal disease. A combined liver-kidney transplantation (CLKT) was done in a 66-year-old patient with alcoholic liver cirrhosis and uremia. Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation (SLPT) was performed in a patient with hepatitis B, hepatocirrhosis, hepatic cellular cancer, and type 1 diabetes. Results The function of kidney grafts became normal 5 days postoperatively and insulin-independent after treatment with low dose insulin for 10 days in the 2 SKPT patients. For the CLKT patient, both transplanted organs rapidly achieved normal functions after operation but suffered-acute liver graft rejection on postoperation day 10 and the rejection was controlled after methylprednisolone pulse therapy. In the SLPT patient, insulin was withdrawn 5 days after operation, liver allograft function recovered well. All the patients are alive with stable allograft function after following-up for 29, 26, 9 and 6 months, respectively. Conclusions Abdominal multi organ transplantation was effective therapy to patients with multiple organ failure. SLPT can reduce acute pancreas rejection and promote the recovery of liver allograft.

目的探讨腹部大器官联合移植治疗腹部多器官功能衰竭的效果。方法2例I型糖尿病并发尿毒症患者施行改良式胰液肠腔引流胰、十二指肠及肾一期联合移植,1例高龄酒精性肝硬化终末期并慢性肾功能不全尿毒症患者施行一期肝肾联合移植,1例慢性乙型病毒性肝炎、肝硬化、原发性肝细胞癌合并胰岛素依赖型糖尿病患者施行同期原位肝-异位胰十二指肠联合移植,观察其临床疗效。结果2例胰肾联合移植患者术后第5天肾功能恢复正常,术后第10天停用胰岛素,2例均分别于术后20、22 d出现消化道出血,经止血治疗后痊愈;肝肾联合移植患者术后第3天移植肝肾功能正常,术后第10天移植肝发生急性排斥反应,抗排斥治疗后逆转;肝胰联合移植患者术后第5天停用胰岛素,移植肝功能恢复正常。4例患者分别随访29、26、9、6月,移植物功能均正常。结论腹部大器官联合移植是腹部多器官功能衰竭的有效治疗方法,肝胰联合移植可减少胰腺的排斥反应,促进移植肝功能恢复。

 
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