资格
胰腺移植s aren't recommended for patients who can manage their diabetes through diet, 药物治疗和其他方法, since the procedure carries all the risks and recovery issues of major surgery, as well as the possibility that the body's immune system will reject the transplanted organ. 防止器官排斥, transplant recipients must take powerful immunosuppressant medications for the rest of their lives. These medications have many side effects and make patients more susceptible to other illnesses.
Patients with type 1 diabetes may be evaluated for pancreas transplants or combined kidney-pancreas transplants. Patients with type 2 diabetes are less likely to be candidates because they may be insulin-resistant, 这意味着他们的身体细胞对胰岛素的反应不正常, 也无法从胰腺移植中获益.
评价
If you became insulin dependent — meaning you began needing insulin injections — at age 18 or older, 我们会要求你做血液测试来测量你的c肽水平, 胰岛素产生的产物.
We'll request a number of other medical tests as part of your evaluation, such as:
- 去年进行了血液检查，包括艾滋病毒检查.
- 去年做过胸部x光检查.
- 非透析患者的肌酐清除率测试. This 24-hour test measures levels of a blood waste product called creatinine in the blood and urine and is used to evaluate kidney function.
- 最近两年内做的超声心动图检查.
- 去年做过的心电图.
- Persantine thallium or comparable test performed within the last two years. 这个测试包括通过静脉注射两种物质:持久性, to help expand the arteries and replicate the effect of vigorous exercise, 和铊, 用x射线探测到的放射性同位素.
- 大便愈创木，一种检查大便中是否有血的方法.
- 肺结核(TB)皮肤试验.
其他检查，如结肠镜检查, 乳房x光检查, Pap smear and prostate specific antigen (PSA) tests - may be needed depending on your sex, 年龄和病史. 我们可能会根据你的结果要求额外的测试.
Our selection committee of transplant doctors and nurses will review any changes in your health. Your transplant eligibility will be reassessed regularly and further medical tests may be needed.
接受器官移植, you must have adequate insurance coverage for your surgery as well as your care and medications after going home from the hospital. Before a final decision is made, we'll request verification of coverage from your insurance provider.
You'll also need a designated caregiver to bring you to clinic appointments and help you at home the first few days after leaving the hospital.
移植的类型
同时进行肾胰移植
One of the most serious complications of type 1 diabetes is end-stage kidney disease, 哪一种可能需要肾脏移植. 如果你接受了肾脏移植而没有胰腺移植, you must continue to take insulin in addition to immunosupressive medications to protect the new kidney. There's also a risk that diabetes will damage the new kidney and other organs.
Successful combined kidney-pancreas transplants prevent diabetes from damaging transplanted kidneys and eliminate the need for insulin therapy. Ideally, a patient receives a new kidney and pancreas from the same donor.
胰腺移植
Improvements in surgical techniques and immunosuppressive medications have made it possible to perform pancreas transplants in diabetic patients who don't yet have serious kidney disease but who have problems maintaining normal blood sugar and insulin levels. 有了这些改进, people who receive pancreas transplants alone are achieving the same excellent results as those who get simultaneous kidney-pancreas transplants.
Advances in preventing organ rejection also make it possible to perform solitary pancreas transplants in patients who've already had successful kidney transplants.
移植胰腺来自已故捐赠者. Transplant kidneys, on the other hand, may come from either deceased or 生活捐助者. 我们鼓励肾移植候选人使用 生活捐助者 如果可能的话. Patients can undergo pancreas transplant six months to a year after a kidney transplant if a pancreas becomes available.
While living kidney donors don't have to be related to the recipient, 他们必须有相容的血型. 有高血压的人, obesity, diabetes or a history of cancer may not be able to donate a kidney.
Because there's a shortage of donor pancreases, patients must wait for an available organ. The length of the wait varies depending on the patient's blood type. Patients who need a pancreas transplant or a combined kidney-pancreas transplant typically don't have to wait as long as those who need just a kidney transplant.
另一种选择是胰岛移植
胰岛移植是一项较新的研究, minimally invasive treatment option for people with type 1 diabetes. 在程序中, insulin-producing beta cells are taken from a donor pancreas and injected the portal vein of the recipient's liver, 它们附着在新血管上并释放胰岛素. 胰岛移植可以暂时逆转糖尿病.
欲了解更多信息，请访问 胰岛移植治疗1型糖尿病.
