膵移植、膵臓移植

関: pancreas graft、pancreas transplantation、pancreatic transplant

WordNet

be transplantable; "These delicate plants do not transplant easily"
an operation moving an organ from one organism (the donor) to another (the recipient); "he had a kidney transplant"; "the long-term results of cardiac transplantation are now excellent"; "a child had a multiple organ transplant two months ago" (同)transplantation, organ_transplant
the act of removing something from one location and introducing it in another location; "the transplant did not flower until the second year"; "too frequent transplanting is not good for families"; "she returned to Alabama because she could not bear transplantation" (同)transplantation, transplanting
place the organ of a donor into the body of a recipient (同)graft
lift and reset in another soil or situation; "Transplant the young rice plants" (同)transfer
a large elongated exocrine gland located behind the stomach; secretes pancreatic juice and insulin

PrepTutorEJDIC

〈植物〉‘を'移植する / (…から他の場所へ)…‘を'移す,〈人〉‘を'移住させる《+名+from+名+to+名》 / (…から…へ)〈組織・器官など〉‘を'移植する《+名+from+名+to+名》 / 移植できる;移住する / 〈C〉移植された物 / 〈U〉移植すること
膵臓(すいぞう)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/08 07:45:06」(JST)

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[Wiki en表示]

A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who usually has diabetes. Because the pancreas is a vital organ, performing functions necessary in the digestion process, the recipient's native pancreas is left in place, and the donated pancreas is attached in a different location. In the event of rejection of the new pancreas which would quickly cause life-threatening diabetes, the recipient could not survive without the native pancreas still in place. The healthy pancreas comes from a donor who has just died or it may be a partial pancreas from a living donor.^[1] At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes, who can develop severe complications. Patients with the most common- and deadliest- form of pancreatic cancer (pancreatic adenomas- which are usually always malignant, with a poor prognosis and high risk for metastasis- as opposed to more treatable pancreatic neuroendocrine tumors or pancreatic insulinomas) are usually not eligible for valuable pancreatic transplantations, since the condition usually has a very high mortality rate and the disease, which is usually highly malignant and detected too late to treat, could and probably would soon return.

Medical uses

In most cases, pancreas transplantation is performed on individuals with type 1 diabetes with end-stage renal disease, brittle diabetes and hypoglycaemia unawareness. The majority of pancreas transplantation (>90%) are simultaneous pancreas-kidney transplantation.^[2] It may also be performed as part of a kidney-pancreas transplantation.

Complications

Complications immediately after surgery include thrombosis, pancreatitis, infection, bleeding and rejection. Rejection may occur immediately or at any time during the patient's life. This is because the transplanted pancreas comes from another organism, thus the recipient's immune system will consider it as an aggression and try to combat it. Organ rejection is a serious condition and ought to be treated immediately. In order to prevent it, patients must take a regimen of immunosuppressive drugs. Drugs are taken in combination consisting normally of cyclosporine, azathioprine and corticosteroids. But as episodes of rejection may reoccur throughout a patient's life, the exact choices and dosages of immunosuppressants may have to be modified over time. Sometimes tacrolimus is given instead of cyclosporine and mycophenolate mofetil instead of azathioprine.

Types

There are four main types of pancreas transplantation:

Pancreas transplant alone, for the patient with type 1 diabetes who usually has severe, frequent hypoglycemia, but adequate kidney function.
Simultaneous pancreas-kidney transplant (SPK), when the pancreas and kidney are transplanted simultaneously from the same deceased donor.
Pancreas-after-kidney transplant (PAK), when a cadaveric, or deceased, donor pancreas transplant is performed after a previous, and different, living or deceased donor kidney transplant.
Simultaneous deceased donor pancreas and live donor kidney (SPLK) has the benefit of lower rate of delayed graft function than SPK and significantly reduced waiting times, resulting in improved outcomes.^[3]

Preservation until implantation

Standard practice is to replace the donor's blood in the pancreatic tissue with an ice-cold organ storage solution, such as UW (Viaspan) or HTK until the allograft pancreatic tissue is implanted.

Prognosis

The prognosis after pancreas transplantation is very good. Over the recent years, long-term success has improved and risks have decreased. One year after transplantation more than 95% of all patients are still alive and 80-85% of all pancreases are still functional. After transplantation patients need lifelong immunosuppression. Immunosuppression increases the risk for a number of different kinds of infection^[4] and cancer.

It is unclear if steroids, which are often used as immunosuppressant, can be replaced with something else.^[5]

History

The first pancreas transplantation was performed in 1966 by the team of Dr. Kelly, Dr. Lillehei, Dr. Merkel, Dr. Idezuki Y, & Dr. Goetz, three years after the first kidney transplantation.^[6] A pancreas along with kidney and duodenum was transplanted into a 28-year-old woman and her blood sugar levels decreased immediately after transplantation, but eventually she died three months later from pulmonary embolism. In 1979 the first living-related partial pancreas transplantation was done.

References

^ Type 1 cures - pancreas transplants
^ Gruesomer AC, Sutherland DE (2005). "Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNIS) and the International Pancreas Transplant Registry (SCRIPT) as of June 2004". Clint Transplant 19 (4): 433–55. doi:10.1111/j.1399-0012.2005.00378.x. PMID 16008587.
^ Farney, Alan; Cho E; Schweitzer EJ; Dunkin B; Philosophe B; Colonna J; Jacobs S; Jarrell B; Flowers JL; Bartlett ST (November 2000). "Simultaneous cadaver pancreas living-donor kidney transplantation: a new approach for the type 1 diabetic uremic patient.". Annals of Surgery 232 (5): 696–703. doi:10.1097/00000658-200011000-00012. PMC 1421224. PMID 11066142.
^ Fishman JA, Rubin RH (1998). "Infection in organ-transplant recipients". N Engl J Med 338 (24): 1741–51. doi:10.1056/NEJM199806113382407. PMID 9624195. Full text
^ Montero, N; Webster, AC; Royuela, A; Zamora, J; Crespo Barrio, M; Pascual, J (Sep 15, 2014). "Steroid avoidance or withdrawal for pancreas and pancreas with kidney transplant recipients.". The Cochrane database of systematic reviews 9: CD007669. doi:10.1002/14651858.CD007669.pub2. PMID 25220222.
^ Kelly WD, Lillehei RC, Merkel FK, Idezuki Y, Goetz FC (1967). "Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy". Surgery 61 (6): 827–37. PMID 5338113.

External links

VIDEO - Last 10 years of pancreas transplantation, by Dixon Kaufman, MD, PhD. University of Wisconsin School of Medicine and Public Health, 2011.
Diabetes Institute for Immunology and Transplantation^{[dead link]}
International Pancreas and Islet Transplant Association
Pancreas transplantation at the University of Illinois at Chicago

UpToDate Contents

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1. 糖尿病における膵臓および膵島移植 pancreas and islet transplantation in diabetes mellitus
2. 糖尿病を合併した腎臓・膵臓移植での患者選択とそれに関連する免疫学的問題 patient selection for and immunologic issues relating to kidney pancreas transplantation in diabetes mellitus
3. 糖尿病における腎臓・膵臓移植と関連した利益および合併症 benefits and complications associated with kidney pancreas transplantation in diabetes mellitus
4. 腎機能と腎臓以外の固形臓器移植 renal function and nonrenal solid organ transplantation
5. 実質臓器移植前の感染の評価 evaluation for infection before solid organ transplantation

English Journal

Distribution pattern of CART-containing neurons and cells in the human pancreas.

Kasacka I, Janiuk I, Lewandowska A, Bekisz A, Lebkowski W.SourceDepartment of Histology and Cytophysiology, Medical University of Bialystok, Kilińskiego 1 str., 15-089 Białystok, Poland.
Acta histochemica.Acta Histochem.2012 Nov;114(7):695-9. Epub 2012 Jan 16.
Cocaine- and amphetamine-regulated transcript (CART) has been shown to play a critical role in appetite suppression, cell survival, thermoregulation, glucose sensing, stimulation of hormone secretion, as well as for the regulatory function of the islets of Langerhans. Although the principal site of
PMID 22257587

TRAIL-engineered pancreas-derived mesenchymal stem cells: characterization and cytotoxic effects on pancreatic cancer cells.

Moniri MR, Sun XY, Rayat J, Dai D, Ao Z, He Z, Verchere CB, Dai LJ, Warnock GL.SourceDepartment of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Cancer gene therapy.Cancer Gene Ther.2012 Sep;19(9):652-8. doi: 10.1038/cgt.2012.46. Epub 2012 Jul 6.
Mesenchymal stem cells (MSCs) have attracted great interest in cancer therapy owing to their tumor-oriented homing capacity and the feasibility of autologous transplantation. Currently, pancreatic cancer patients face a very poor prognosis, primarily due to the lack of therapeutic strategies with an
PMID 22767216

Japanese Journal

膵腎同時移植の長期予後

脇嘉代
内分泌・糖尿病・代謝内科 35(2), 155-163, 2012-08
NAID 40019419144

Evaluation of the Presumable Incidence of Pancreatic Islet Cell Transplantation in Nagasaki

Tanaka Takayuki.et.al
Acta medica Nagasakiensia 57(2), 45-48, 2012-07
… A previous report presented the expected annual incidence of ICT recipients in NagasakiPrefecture in 2006.2),3) This report presents variations in the background of T1DM patients followed in this department andevaluated the current annual incidence of possible ICT recipients.MethodsThis study reviewed 128 TIDM patients followed at Nagasaki University Hospital in 2011, examined the annual incidence ofICT recipients based on the Japanese Islet Transplant Registry criteria and the population of Nagasaki, and compared thoseresults in 2011 with those in …
NAID 110009442902

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★リンクテーブル★

リンク元	「膵移植」「pancreas graft」「pancreatic transplant」「膵臓移植」
関連記事	「transplant」

「膵移植」

Pancreas transplantation
	Intervention
	Pancreas transplant ex-situ prepared with reconstruction of arteries and lengthening of the portal vein
ICD-9-CM	52.8
MeSH	D016035
MedlinePlus	003007

　　[★]

英: pancreas transplantation、pancreas transplant、pancreas graft、pancreatic transplant
関: 膵臓移植

「pancreas graft」

　　[★]

膵移植

関: pancreas transplant、pancreas transplantation、pancreatic transplant

「pancreatic transplant」

　　[★]

膵移植

関: pancreas graft、pancreas transplant、pancreas transplantation

「膵臓移植」

　　[★]

英: pancreas transplantation、pancreas transplant
関: 膵移植

「transplant」

　　[★]

n.

移植片、移植

v.

移植する

関: cell transplant、engraft、engraftment、explant、graft、grafting、implant、implantation、organ graft、organ transplant、tissue graft、tissue transplant、transfer、transplant recipient、transplantation

[1] Type 1 cures - pancreas transplants

[2] Gruesomer AC, Sutherland DE (2005). "Pancreas transplant outcomes for United States (US) and non-US cases as reported to the United Network for Organ Sharing (UNIS) and the International Pancreas Transplant Registry (SCRIPT) as of June 2004". Clint Transplant 19 (4): 433–55. doi:10.1111/j.1399-0012.2005.00378.x. PMID 16008587.

[3] Farney, Alan; Cho E; Schweitzer EJ; Dunkin B; Philosophe B; Colonna J; Jacobs S; Jarrell B; Flowers JL; Bartlett ST (November 2000). "Simultaneous cadaver pancreas living-donor kidney transplantation: a new approach for the type 1 diabetic uremic patient.". Annals of Surgery 232 (5): 696–703. doi:10.1097/00000658-200011000-00012. PMC 1421224. PMID 11066142.

[4] Fishman JA, Rubin RH (1998). "Infection in organ-transplant recipients". N Engl J Med 338 (24): 1741–51. doi:10.1056/NEJM199806113382407. PMID 9624195. Full text

[5] Montero, N; Webster, AC; Royuela, A; Zamora, J; Crespo Barrio, M; Pascual, J (Sep 15, 2014). "Steroid avoidance or withdrawal for pancreas and pancreas with kidney transplant recipients.". The Cochrane database of systematic reviews 9: CD007669. doi:10.1002/14651858.CD007669.pub2. PMID 25220222.

[6] Kelly WD, Lillehei RC, Merkel FK, Idezuki Y, Goetz FC (1967). "Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy". Surgery 61 (6): 827–37. PMID 5338113.

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pancreas transplant