肝、胰Ⅰ期联合移植治疗合并糖尿病的良性终末期肝病一例

目的 对1例原位肝、异位胰腺I期联合移植进行总结.方法 对1例终末期肝病合并2型糖尿病的患者施行肝、胰I期联合移植,肝脏为原位移植,胰腺异位移植于右侧髂窝,胰液空肠引流.术后采用他克莫司、霉酚酸酯及糖皮质激素预防排斥反应,并辅以两剂达利珠单抗.结果 术后移植胰腺功能良好,第2天即停用胰岛素.术后14 d,移植肝出现轻度急性排斥反应,调整他克莫司的用量后逆转.受者已存活15个月,移植肝脏及胰腺功能均正常.结论 肝、胰联合移植是治疗终末期肝病合并糖尿病的有效方法.

Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in an end-stage liver disease patient with diabetes

Objective To summarize a case of simultaneous orthotopic liver and heterotopic Pancrefls-duodenum transplantation.Methods One patient with end-stage liver disease and type 2 diabetes mellitus received simultaneous liver-pancreas-duodenum transplantation.liver transplantation was performed orthotopically,while pancrease was transplanted to right iliac fossa with enteric drainage of the exocrine secretions.FK506,mycophenolate mofetil(MMF),steroid and two doses of daclizumab were given tO prevent rejection.Results The function of pancreas allograft was recovered immediately and the patient became insulin independence on day 2 postoperation.The liver allograft had an acute rejection episode on day 14 after operation and reversed by adjusting FK506 dose.The recipient was currently liver disease free and insulin free more than 15 months.Conclusion The simultaneous liverpancreas-duodenum transplantation is an effective method in the treatment of end-stage liver disease with diabetes mellitus.