胰肾联合移植中供体切取和修整的技巧

目的:总结胰肾一期联合移植中供体胰十二指肠及肾脏切取及修整的经验。方法:回顾性分析19例胰肾联合移植术中供体胰十二指肠及肾脏切取的方法与移植物的修整技巧。结果:无1例发生移植物损伤。联合移植术后9 d之内18例完全停用外源性胰岛素,空腹血糖正常，尿糖≤（+）。术后2～4 d，血肌酐和尿素氮降至正常。3例出现移植肾脏急性排斥反应，2例发生移植胰腺急性排斥反应，给予甲泼尼龙冲击治疗后恢复正常。1例术后因移植物加速排斥反应，术后11 d切除移植胰、肾。结论:胰肾联合移植手术中，供体胰十二指肠及肾脏的切取及修整是手术成功的重要因素之一。

The skill of allograft procurement and trimming in simultaneous pancreas-kidney transplantation

Abstract:Objective:To sum up the harvesting and trimming (bench surgery) experience of simultaneous pancreas-kidney (SPK) transplantation.Methods :Retrospectively analysis of the methods of harvesting and skill of trimming in 19 cases of SPK transplantation was made.Results:No injury of allograft occurred. Exogenous insulin was discontinued within 9 day after operation in 18 patients, and their fasting blood sugar was normal, and urine sugar was negative or(+). Serum creatinine and urea nitrogen became normal at 2-4 d postoperatively. Three transplanted kidney and 2 transplanted pancreas had acute rejection (AR), and all the AR were disappeared after anti-rejection therapy. The SPK grafts in 1 patient was excised on 11 d postoperatively due to accelerated rejection. Conclusions:The skill of procurement and bench surgery trimming of allograft in one of the key factors for successful SPK.