同种胰腺移植后二年余低血糖昏迷一例

作者对一例I型糖尿病伴有血管和眼继发症的女性患者,作了胰管阻塞式胰腺节段移植术。用Cs A—Aza—Pred作免疫抑制处理。于术后190日内度过了5次急性排斥,第4次排斥后胰岛功能显示部分障碍。移植胰于术后13日病理活检就出现严重纤维化。Gomeri染色发现B细胞在数量和质量上均有轻度损害。患者因肾病综合征于1987年7月13日死于急性肾衰和低血糖昏迷,移植胰有功能存活超过2年。作者认为多次排斥可影响胰岛功能,而移植胰和长期纤维化对胰岛的功能则影响不大,患者于死亡前发生低血糖昏迷可证实死亡时移植胰是有一定功能的。低血糖昏迷的原因复杂,可能是练合因素造成的,尚待实践进一步观察和研究。

Hypoglycemic coma after pancreatic allograft

This peper reports a girl aged 29, who suffered from I DDM 11 years ago,wes operated on for a pancreatic allograft on June 4, 1985. A triple immunosu-ppressive protocol as Csa--Aza--Pred was selected. She had passed 5 onsets ofacute rejection, and slight harm was seen in her graf after the fourth onset. Severefibrosis could be found in the biopsy 13 days after grafting, and the B--cells seemedto decreas both in number and size under the Gomeri's stain. This recipient diedof acute renal failure and hypolycemic coma following nephrosis on July 13, 1987.Her graft was functioning over 2 years. The authors think that frequent onsets ofrejection in a short period may be harmful to the islets, but severe fibrosis of thegraft for a long period is not harmful.The mechanism of hypog lycemic coma after pancreaticallograft is very complicated. This problem will also challenge us to do furtherstudied for the hypoglycemic coma after pencreas transplantation when renal failuredevelops.