A veseelégtelenséggel szövődött 1-es típusú diabetes mellitus esetében a betegek életkilátása rosszabb, mint néhány rosszindulatú betegségben szenvedő betegé. A vesepótló kezelések minden formája közül a szimultán hasnyálmirigy-vese transzplantáció biztosítja a legjobb betegtúlélési eredményeket. A műtéti technika és az immunszuppressziós kezelés az elmúlt évtized során egyre inkább egységesült. Bár a transzplantálható szervek száma messze elmarad az igény mögött, a szimultán hasnyálmirigy-vese átültetés a legeredményesebb kezelési alternatívaként ajánlható az arra alkalmas betegeknek. A hazai két hasnyálmirigy-transzplantációs programban elvégzett több mint 100 szimultán hasnyálmirigy-vese transzplantáció eredményei összhangban vannak a nemzetközi eredményekkel. Orv. Hetil., 2013, 154, 850–856.
Fourlanos, S., Harrison, L. C., Colman, P. G.: The accelerator hypothesis and increasing incidence of type 1 diabetes. Curr. Opin. Endocrinol. Diabetes Obes., 2008, 15, 321–325.
Colman P. G. , 'The accelerator hypothesis and increasing incidence of type 1 diabetes ' (2008 ) 15 Curr. Opin. Endocrinol. Diabetes Obes. : 321 -325 .
Becker, B. N., Brazy, P. C., Becker, Y. T., et al.: Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease. Kidney Int., 2000, 57, 2129–2135.
Becker Y. T. , 'Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease ' (2000 ) 57 Kidney Int. : 2129 -2135 .
Reddy, K. S., Stablein, D., Taranto, S., et al.: Long-term survival following simultaneous kidney-pancreas transplantation versus kidney transplantation alone in patients with type 1 diabetes mellitus and renal failure. Am. J. Kidney Dis., 2003, 41, 464–470.
Taranto S. , 'Long-term survival following simultaneous kidney-pancreas transplantation versus kidney transplantation alone in patients with type 1 diabetes mellitus and renal failure ' (2003 ) 41 Am. J. Kidney Dis. : 464 -470 .
Smets, Y. F., Westendorp, R. G., van der Pijl, J. W., et al.: Effect of simultaneous pancreas-kidney transplantation on mortality of patients with type-1 diabetes mellitus and end-stage renal failure. Lancet, 1999, 353, 1915–1919.
Pijl J. W. , 'Effect of simultaneous pancreas-kidney transplantation on mortality of patients with type-1 diabetes mellitus and end-stage renal failure ' (1999 ) 353 Lancet : 1915 -1919 .
Tydén, G., Bolinder, J., Solders, G., et al.: Improved survival in patients with insulin-dependent diabetes mellitus and end-stage diabetic nephropathy 10 years after combined pancreas and kidney transplantation. Transplantation, 1999, 67, 645–648.
Solders G. , 'Improved survival in patients with insulin-dependent diabetes mellitus and end-stage diabetic nephropathy 10 years after combined pancreas and kidney transplantation ' (1999 ) 67 Transplantation : 645 -648 .
Kelly, W. D., Lillehei, R. C., Merkel, F. K., et al.: Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy. Surgery, 1967, 61, 827–837.
Merkel F. K. , 'Allotransplantation of the pancreas and duodenum along with the kidney in diabetic nephropathy ' (1967 ) 61 Surgery : 827 -837 .
Kalmár Nagy, K., Baumann, J., Szakály, P., et al.: Simultaneous pancreas-kidney transplantation – an alternative option for the treatment of type 1 diabetes mellitus with renal failure. [Szimultán hasnyálmirigy-vese transzplantáció – a veseelégtelenséggel szövődött 1-es típusú diabetes mellitus kezelésének alternatívája.] Orv. Hetil., 2004, 145, 1259–1264. [Hungarian]
Szakály P. , 'Simultaneous pancreas-kidney transplantation – an alternative option for the treatment of type 1 diabetes mellitus with renal failure. [Szimultán hasnyálmirigy-vese transzplantáció – a veseelégtelenséggel szövődött 1-es típusú diabetes mellitus kezelésének alternatívája.] ' (2004 ) 145 Orv. Hetil. : 1259 -1264 .
Gruessner, R. W., Sutherland, D. E., Kandaswamy, R., et al.: Over 500 solitary pancreas transplants in nonuremic patients with brittle diabetes mellitus. Transplantation, 2008, 85, 42–47.
Kandaswamy R. , 'Over 500 solitary pancreas transplants in nonuremic patients with brittle diabetes mellitus ' (2008 ) 85 Transplantation : 42 -47 .
Sampaio, M. S., Kuo, H. T., Bunnapradist, S.: Outcomes of simultaneous pancreas-kidney transplantation in type 2 diabetic recipients. Clin. J. Am. Soc. Nephrol., 2011, 6, 1198–1206.
Bunnapradist S. , 'Outcomes of simultaneous pancreas-kidney transplantation in type 2 diabetic recipients ' (2011 ) 6 Clin. J. Am. Soc. Nephrol. : 1198 -1206 .
Bazerbachi, F., Selzner, M., Boehnert, M. U., et al.: Thymoglobulin versus basiliximab induction therapy for simultaneous kidney-pancreas transplantation: impact on rejection, graft function, and long-term outcome. Transplantation, 2011, 92, 1039–1043.
Boehnert M. U. , 'Thymoglobulin versus basiliximab induction therapy for simultaneous kidney-pancreas transplantation: impact on rejection, graft function, and long-term outcome ' (2011 ) 92 Transplantation : 1039 -1043 .
Esmatjes, E., Fernández, C., Rueda, S., et al.: The utility of the C-peptide in the phenotyping of patients candidates for pancreas transplantation. Clin. Transplant., 2007, 21, 358–362.
Rueda S. , 'The utility of the C-peptide in the phenotyping of patients candidates for pancreas transplantation ' (2007 ) 21 Clin. Transplant. : 358 -362 .
Wiseman, A. C., Gralla, J.: Simultaneous pancreas kidney transplant versus other kidney transplant options in patients with type 2 diabetes. Clin. J. Am. Soc. Nephrol., 2012, 7, 656–664.
Gralla J. , 'Simultaneous pancreas kidney transplant versus other kidney transplant options in patients with type 2 diabetes ' (2012 ) 7 Clin. J. Am. Soc. Nephrol. : 656 -664 .
Schweitzer, E. J., Anderson, L., Kuo, P. C., et al.: Safe pancreas transplantation in patients with coronary artery disease. Transplantation, 1997, 63, 1294–1299.
Kuo P. C. , 'Safe pancreas transplantation in patients with coronary artery disease ' (1997 ) 63 Transplantation : 1294 -1299 .
Van der Werf, W. J., Odorico, J., D’Alessandro, A. M., et al.: Utilization of pediatric donors for pancreas transplantation. Transplant. Proc., 1999, 31, 610–611.
D’Alessandro A. M. , 'Utilization of pediatric donors for pancreas transplantation ' (1999 ) 31 Transplant. Proc. : 610 -611 .
Illanes, H. G., Quarin, C. M., Maurette, R., et al.: Use of small donors (<28 kg) for pancreas transplantation. Transplant. Proc., 2009, 41, 2199–2201.
Maurette R. , 'Use of small donors (<28 kg) for pancreas transplantation ' (2009 ) 41 Transplant. Proc. : 2199 -2201 .
Salvalaggio, P. R., Davies, D. B., Fernandez, L. A., et al.: Outcomes of pancreas transplantation in the United States using cardiac-death donors. Am. J. Transplantation, 2006, 6 (5 Pt 1), 1059–1065.
Fernandez L. A. , 'Outcomes of pancreas transplantation in the United States using cardiac-death donors ' (2006 ) 6 Am. J. Transplantation : 1059 -1065 .
Qureshi, M. S., Callaghan, C. J., Bradley, J. A., et al.: Outcomes of simultaneous pancreas-kidney transplantation from brain-dead and controlled circulatory death donors. Br. J. Surg., 2012, 99, 831–838.
Bradley J. A. , 'Outcomes of simultaneous pancreas-kidney transplantation from brain-dead and controlled circulatory death donors ' (2012 ) 99 Br. J. Surg. : 831 -838 .
Gruessner, A. C., Sutherland, D. E.: Pancreas transplant outcomes for United States (US) cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR). Clin. Transpl., 2008, 22, 45–56.
Sutherland D. E. , 'Pancreas transplant outcomes for United States (US) cases as reported to the United Network for Organ Sharing (UNOS) and the International Pancreas Transplant Registry (IPTR) ' (2008 ) 22 Clin. Transpl. : 45 -56 .
Salvalaggio, P. R., Schnitzler, M. A., Abbot, K. C., et al.: Patient and graft survival implications of simultaneous pancreas kidney transplantation from old donors. Am. J. Transplant., 2007, 7, 1561–1571.
Abbot K. C. , 'Patient and graft survival implications of simultaneous pancreas kidney transplantation from old donors ' (2007 ) 7 Am. J. Transplant. : 1561 -1571 .
Sollinger, H. W., Vernon, W. B., D’Alessandro, A. M., et al.: Combined liver and pancreas procurement with Belzer-UW solution. Surgery, 1989, 106, 685–690.
D’Alessandro A. M. , 'Combined liver and pancreas procurement with Belzer-UW solution ' (1989 ) 106 Surgery : 685 -690 .
Stewart, Z. A., Cameron, A. M., Singer, A. L., et al.: Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival in pancreas transplantation. Am. J. Transplant., 2009, 9, 217–221.
Singer A. L. , 'Histidine-tryptophan-ketoglutarate (HTK) is associated with reduced graft survival in pancreas transplantation ' (2009 ) 9 Am. J. Transplant. : 217 -221 .
Sollinger, H. W., Odorico, J. S., Becker, Y. T., et al.: One thousand simultaneous pancreas-kidney transplants at a single center with 22 year follow-up. Ann. Surg., 2009, 250, 618–630.
Becker Y. T. , 'One thousand simultaneous pancreas-kidney transplants at a single center with 22 year follow-up ' (2009 ) 250 Ann. Surg. : 618 -630 .
Cook, K., Sollinger, H. W., Warner, T., et al.: Pancreaticocystostomy: an alternative method for exocrine drainage of segmental pancreatic allografts. Transplantation, 1983, 35, 634–636.
Warner T. , 'Pancreaticocystostomy: an alternative method for exocrine drainage of segmental pancreatic allografts ' (1983 ) 35 Transplantation : 634 -636 .
Prieto, M., Sutherland, D. E., Fernandez-Cruz, L., et al.: Experimental and clinical experience with urine amylase monitoring for early diagnosis of rejection in pancreas transplantation. Transplantation, 1987, 43, 73–79.
Fernandez-Cruz L. , 'Experimental and clinical experience with urine amylase monitoring for early diagnosis of rejection in pancreas transplantation ' (1987 ) 43 Transplantation : 73 -79 .
West, M., Gruessner, A. C., Metrakos, P., et al.: Conversion from bladder to enteric drainage after pancreaticoduodenal transplantations. Surgery, 1998, 124, 883–893.
Metrakos P. , 'Conversion from bladder to enteric drainage after pancreaticoduodenal transplantations ' (1998 ) 124 Surgery : 883 -893 .
Di Carlo, V., Castoldi, R., Cristallo, M., et al.: Techniques of pancreas transplantation through the world: an IPITA center survey. Transplant. Proc., 1998, 30, 231–241.
Cristallo M. , 'Techniques of pancreas transplantation through the world: an IPITA center survey ' (1998 ) 30 Transplant. Proc. : 231 -241 .
Diem, P., Abid, M., Redmon, J. B., et al.: Systemic venous drainage of pancreas allografts as independent cause of hyperinsulinemia in type I diabetic recipients. Diabetes, 1990, 39, 534–540.
Redmon J. B. , 'Systemic venous drainage of pancreas allografts as independent cause of hyperinsulinemia in type I diabetic recipients ' (1990 ) 39 Diabetes : 534 -540 .
Gaber, A. O., Shokouh-Amiri, H., Grewal, H. P., et al.: A technique for portal pancreatic transplantation with enteric drainage. Surg. Gynecol. Obstet., 1993, 177, 417–419.
Grewal H. P. , 'A technique for portal pancreatic transplantation with enteric drainage ' (1993 ) 177 Surg. Gynecol. Obstet. : 417 -419 .
Boden, G., Chen, X., Ruiz, J., et al.: Insulin receptor down-regulation and impaired antilipolytic action of insulin in diabetic patients after pancreas/kidney transplantation. J. Clin. Endocrinol. Metab., 1994, 78, 657–663.
Ruiz J. , 'Insulin receptor down-regulation and impaired antilipolytic action of insulin in diabetic patients after pancreas/kidney transplantation ' (1994 ) 78 J. Clin. Endocrinol. Metab. : 657 -663 .
Stratta, R. J.: Surgical nuances in pancreas transplantation. Transplant. Proc., 2005, 37, 1291–1293.
Stratta R. J. , 'Surgical nuances in pancreas transplantation ' (2005 ) 37 Transplant. Proc. : 1291 -1293 .
Petruzzo, P., Lefrancois, N., Berthillot, C., et al.: Impact of pancreatic venous drainage site on long-term patient and graft outcome in simultaneous pancreas-kidney transplantation. Clin. Transplant., 2008, 22, 107–112.
Berthillot C. , 'Impact of pancreatic venous drainage site on long-term patient and graft outcome in simultaneous pancreas-kidney transplantation ' (2008 ) 22 Clin. Transplant. : 107 -112 .
Meier-Kriesche, H. U., Li, S., Gruessner, R. W., et al.: Immunosuppression: evolution in practice and trends, 1994–2004. Am. J. Transplant., 2006, 6 (5 Pt 2), 1111–1131.
Gruessner R. W. , 'Immunosuppression: evolution in practice and trends, 1994–2004 ' (2006 ) 6 Am. J. Transplant. : 1111 -1131 .
Gallon, L. G., Winoto, J., Chhabra, D., et al.: Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus. Transplantation, 2007, 83, 1324–1329.
Chhabra D. , 'Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus ' (2007 ) 83 Transplantation : 1324 -1329 .
Knight, R. J., Kerman, R. H., McKissick, E., et al.: Selective corticosteroid and calcineurin-inhibitor withdrawal after pancreas-kidney transplantation utilizing thymoglobulin induction and sirolimus maintenance therapy. Clin. Transplant., 2008, 22, 645–650.
McKissick E. , 'Selective corticosteroid and calcineurin-inhibitor withdrawal after pancreas-kidney transplantation utilizing thymoglobulin induction and sirolimus maintenance therapy ' (2008 ) 22 Clin. Transplant. : 645 -650 .
Muthusamy, A. S., Vaidya, A. C., Sinha, S., et al.: Alemtuzumab induction and steroid-free maintenance immunosuppression in pancreas transplantation. Am. J. Transplant., 2008, 8, 2126–2131.
Sinha S. , 'Alemtuzumab induction and steroid-free maintenance immunosuppression in pancreas transplantation ' (2008 ) 8 Am. J. Transplant. : 2126 -2131 .
Weng, F. L., Patel, A. M., Wanchoo, R., et al.: Oral ganciclovir versus low-dose valganciclovir for prevention of cytomegalovirus disease in recipients of kidney and pancreas transplants. Transplantation, 2007, 83, 290–296.
Wanchoo R. , 'Oral ganciclovir versus low-dose valganciclovir for prevention of cytomegalovirus disease in recipients of kidney and pancreas transplants ' (2007 ) 83 Transplantation : 290 -296 .
Burke, G. W. 3rd, Ciancio, G., Figueiro, J., et al.: Hypercoagulable state associated with kidney-pancreas transplantation. Thromboelastogram-directed anti-coagulation and implications for future therapy. Clin. Transplant., 2004, 18, 423–428.
Figueiro J. , 'Hypercoagulable state associated with kidney-pancreas transplantation. Thromboelastogram-directed anti-coagulation and implications for future therapy ' (2004 ) 18 Clin. Transplant. : 423 -428 .
Waki, K., Kadowaki, T.: An analysis of long-term survival from the OPTN/UNOS Pancreas Transplant Registry. Clin. Transpl., 2007, 21, 9–17.
Kadowaki T. , 'An analysis of long-term survival from the OPTN/UNOS Pancreas Transplant Registry ' (2007 ) 21 Clin. Transpl. : 9 -17 .
Witczak, B. J., Jenssen, T., Endresen, K., et al.: Risk factors for mortality in diabetic nephropathy patients accepted for transplantation. Transplantation, 2007, 84, 356–361.
Endresen K. , 'Risk factors for mortality in diabetic nephropathy patients accepted for transplantation ' (2007 ) 84 Transplantation : 356 -361 .
Beggs, J. L., Johnson, P. C., Olafsen, A. G., et al.: Regression of perineurial cell basement membrane in a human diabetic following isogenic pancreas transplant. Acta Neuropathol. (Berl.), 1989, 79, 108–112.
Olafsen A. G. , 'Regression of perineurial cell basement membrane in a human diabetic following isogenic pancreas transplant ' (1989 ) 79 Acta Neuropathol. (Berl.) : 108 -112 .
Orloff, M. J., Macedo, A., Greenleaf, G. E.: Effect of pancreas transplantation on diabetic somatic neuropathy. Surgery, 1988, 104, 437–444.
Greenleaf G. E. , 'Effect of pancreas transplantation on diabetic somatic neuropathy ' (1988 ) 104 Surgery : 437 -444 .
Giannarelli, R., Coppelli, A., Sartini, M., et al.: Effects of pancreas-kidney transplantation on diabetic retinopathy. Transpl. Int., 2005, 18, 619–622.
Sartini M. , 'Effects of pancreas-kidney transplantation on diabetic retinopathy ' (2005 ) 18 Transpl. Int. : 619 -622 .
Koznarová, R., Saudek, F., Sosna, T., et al.: Beneficial effect of pancreas and kidney transplantation on advanced diabetic retinopathy. Cell Transplant., 2000, 9, 903–908.
Sosna T. , 'Beneficial effect of pancreas and kidney transplantation on advanced diabetic retinopathy ' (2000 ) 9 Cell Transplant. : 903 -908 .