تعريف
Islet cells are the cells in the pancreas that make insulin. Pancreatic islet cell transplantation is the transfer of islet cells from a donor to another person. The procedure is being studied as a method to treat select patients with chronic uncontrolled type 1 (and some type 2) diabetes.
أسباب هذا الإجراء
Pancreatic islet cells are made up of alpha and beta cells. Type 1 diabetes develops when the beta cells in the pancreas are destroyed. They are destroyed by the body’s own الجهاز المناعي. Without these cells, the body is unable to make insulin. As a result, people with type 1 diabetes need daily insulin injections.
Transplants are most commonly used for persons with recurrent severe hypoglycemia (low blood sugars) and/or who are also receiving kidney transplants. Newly transplanted islet cells can produce insulin. This allow better daily control of the blood sugars with a lower risk of hypoglycemia.
المضاعفات المحتملة
If you are planning to have a transplant, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:
- Toxicity from immunosuppressive agents
- Injury to the liver or the pancreas
- Cholesterol problems
- Sensitization—The recipient may form antibodies to future islet cells for repeat transplant.
- Nausea, vomiting, and abdominal pain
- نزيف
- العدوى
- Blood clots
- Worsening of kidney function
- Worsening of high blood pressure
تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:
- التدخين
- مرض كلوي
- اضطرابات النزيف
ما يمكن توقعه
قبل الإجراء
A review board will determine if you will be eligible for a transplant. Once on the transplant list, one may have to wait months or years for a suitable donor.
Your doctor will order blood tests. A physical exam will be done. These tests will assess the extent and severity of diabetic complications. This includes damage to the kidneys. The donor must also be carefully screened for blood and serum matching.
التخدير
Local or general anesthesia may be used. Local will numb the area. You will be asleep with general anesthesia.
الوصف الداخلي
Pancreas transplant surgery is major surgery and requires special expertise in select medical centers. The cells are delicate and may fail even in the best of circumstances.
Before surgery, islet cells are removed from a donor pancreas. Usually, these cells are used within the next 24 hours.
An incision will be made in the abdomen. A small plastic tube will be placed through the incision and into a major blood vessel of the liver. An ultrasound will be used to locate the right position. Islets cells will be injected through the tube. The cells travel through the vein and attach to the liver. When successful, they will begin making insulin.
مباشرة بعد الإجراء
Your blood glucoses may be normal immediately following transplantation.
Your immune system may attack the transferred cells. To prevent this type of attack, called rejection, you will be given medicines to suppress your immune system.
Similar medicines to suppress the immune system are usually needed for the rest of the person’s life to prevent rejection.
كم من الوقت سيستغرق ؟
Generally several hours
كم هو مؤلم ؟
The area of surgical incision may sting or burn. Anesthesia will prevent pain during the procedure. After the procedure, some patients experience pain or soreness for a few days. If you have discomfort, ask your doctor about pain medicine.
متوسط الإقامة في المستشفى
4-10 days
رعاية ما بعد العملية
- Keep the incision wound clean.
- Follow your doctor’s instructions about wound care.
- Check your blood glucose frequently. Follow your doctor’s instructions.
- Closely control blood sugar levels with insulin.
Your doctor may repeat the process several times to transfer more islet cells.
استدعاء الطبيب
بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
- سعال ، ضيق تنفس ، ألم في الصدر ، غثيان أو قيء شديد
- High or low blood glucose levels
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.