膵移植

関: pancreas graft、pancreas transplant、pancreas transplantation

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
of or involving the pancreas; "pancreatic cancer"

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
膵臓の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/07 12:49:43」(JST)

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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. 1型糖尿病における血糖コントロールおよび血管合併症 glycemic control and vascular complications in type 1 diabetes mellitus

English Journal

The role of exendin-4-conjugated superparamagnetic iron oxide nanoparticles in beta-cell-targeted MRI.

Zhang B, Yang B, Zhai C, Jiang B, Wu Y.SourceDepartment of Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Zhejiang Province, Hangzhou 310009, PR China.
Biomaterials.Biomaterials.2013 Jul;34(23):5843-52. doi: 10.1016/j.biomaterials.2013.04.021. Epub 2013 May 2.
Noninvasive targeted visualization of pancreatic beta cells or islets is becoming the focus of molecular imaging application in diabetes and islet transplantation studies, but it is currently unsuccessful due to the lack of specific beta cell biomarkers. Glucagon-like peptide 1 receptor (GLP-1R) is
PMID 23642536

Porcine pancreas extracellular matrix as a platform for endocrine pancreas bioengineering.

Mirmalek-Sani SH, Orlando G, McQuilling JP, Pareta R, Mack DL, Salvatori M, Farney AC, Stratta RJ, Atala A, Opara EC, Soker S.SourceWake Forest Institute for Regenerative Medicine, Winston Salem, NC, USA.
Biomaterials.Biomaterials.2013 Jul;34(22):5488-95. doi: 10.1016/j.biomaterials.2013.03.054. Epub 2013 Apr 10.
Emergent technologies of regenerative medicine have the potential to overcome the limitations of organ transplantation by supplying tissues and organs bioengineered in the laboratory. Pancreas bioengineering requires a scaffold that approximates the biochemical, spatial and vascular relationships of
PMID 23583038

Impacts of TCF7L2 gene polymorphisms on the susceptibility of hepatogenous diabetes and hepatocellular carcinoma in cirrhotic patients.

Ling Q, Dong F, Geng L, Liu Z, Xie H, Xu X, Zheng S.SourceKey Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Gene.Gene.2013 Jun 15;522(2):214-8. doi: 10.1016/j.gene.2013.03.089. Epub 2013 Apr 2.
BACKGROUND: Hepatogenous diabetes (HD) occurs as a complication of cirrhosis. Whether genetic factors, rather than only liver damage, play roles in the development of HD is unknown. TCF7L2 gene has been reported to be associated with type 2 diabetes and also cancer risks. We aim to evaluate the impa
PMID 23558246

Japanese Journal

生体肝移植7年後にinterface hepatitis を呈し特発性移植後肝炎と診断した1例

日本小児外科学会雑誌 52(2), 264-269, 2016
NAID 130005147379

Use of simeprevir following pre-emptive pegylated interferon/ribavirin treatment for recurrent hepatitis C in living donor liver transplant recipients : a 12-week pilot study

Journal of hepato-biliary-pancreatic
NAID 40020363673

I-4．急性膵炎の膵局所合併症に対するインターベンション治療

膵臓 30(6), 755-760, 2015
NAID 130005126572

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★リンクテーブル★

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

「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 transplant」

　　[★]

膵移植、膵臓移植

関: pancreas graft、pancreas transplantation、pancreatic transplant

「pancreas graft」

　　[★]

膵移植

関: pancreas transplant、pancreas transplantation、pancreatic transplant

「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

「pancreatic」

　　[★]

adj.

膵臓の、膵性の、膵の

関: pancreas、pancreata

[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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案内

pancreatic transplant