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目的 :探讨胰肾联合移植的供体器官切取及移植手术方法。方法 :2 0 0 1年 10月施行 1例胰液肠腔引流式胰、十二指肠及肾联合移植 ,手术分 3个步骤 :①供体腹部多器官 (包括胰、肝脏、肾脏 )联合原位灌洗、整块切取 ;②供胰、供肾的修整 ;③供胰和供肾的植入。监测术后胰腺、肾的功能恢复。结果 :联合整块切取腹部多器官成功 ,热缺血时间在 3min之内。施行 1例胰液肠腔引流式胰、十二指肠及肾联合移植 ,术后移植肾功能在术后第 3d肌酐、尿素氮恢复正常 ;第 5d停用胰岛素 ,移植胰内外分泌功能正常。随访 1年 ,人 /移植物存活良好。结论 :胰、十二指肠及肾联合移植是治疗胰岛素依赖型糖尿病并发尿毒症的有效方法 ,供体腹部多器官联合原位灌洗、整块切取的方法可有效缩短器官的热缺血时间 ,减少损伤和提高供体器官的利用率。
Objective: To explore the methods of donor organ extraction and transplantation in pancreas-kidney transplantation. Methods: One case of pancreas drainage in the intestine of pancreas was performed in October 2001. The procedure consisted of three steps: (1) multiple organs (including pancreas, liver and kidney) Lavage, the whole cut; ② for the pancreas, kidney for dressing; ③ for pancreatic and donor kidney implantation. Monitoring postoperative pancreas, kidney function recovery. Results: The combined multi-organ ablation cut the whole body, warm ischemic time within 3min. One case of pancreatic juice intestine draining pancreas, duodenum and kidney transplantation, postoperative transplant renal function in the first postoperative 3d creatinine, urea nitrogen returned to normal; the first 5d disable insulin, pancreatic endocrine and exocrine function. One year follow-up, human / graft survival is good. Conclusions: Combined pancreas, duodenum and kidney transplantation is an effective method for the treatment of uremia in patients with insulin-dependent diabetes mellitus. In-situ lavage combined with multiple organs in the donor’s abdomen can effectively shorten the organ ischemia time , Reduce damage and improve donor organ utilization.