Chapter 28 – Kidney and Pancreas Transplantation

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1、CHAPTER28KIDNEYANDPANCREASTRANSPLANTATIONYolandaBeckertechnique,andoutcomesofkidneyandpancreastransplantationhistoricalperspectivearediscussedindependently.kidneytransplantationpancreastransplantationKIDNEYTRANSPLANTATIONislettransplantationIndicationsKidneytransplanta

2、tionofferspatientsbetterlong-termout-HISTORICALPERSPECTIVEcomesthandialysis.ThequalityoflifeisimprovedandsurvivalInterestintransplantingorgansintohumansdatesbacktotheisprojectedtobe10yearslongerthanifthepatientremainson1early1900s.Florescodescribedanastomosisoftherenal

3、grafttodialysis.Duringthepastdecade,thekidneywaitinglisthastheiliacfossain1905.In1906,Jaboulayattemptedtouseagrownandthedeathofcandidateswhodiewhilewaitinghaspigkidneytocureapatientwithacutenephritis.Heanasto-doubled.Thisreflectsachangeindemographicsintherecipientmosed

4、therenalxenografttothebrachialarteriesofthepatientwaitinglist,withpatientslistedatolderagesandanincreasing2andurinewasnotedfor1hourpostreperfusion.AlexisCarrelnumberofpatientsbeinginactiveonthewaitinglist.wasdevelopingtechniquesoftriangulationofvascularanasto-Themostco

5、mmoncausesofrenaldiseasehaveevolvedmosesbyperformingvariousorgantransplantsinanimalsandoverthelast10years.Overall,thepercentageofpatientswithreceivedtheNobelPrizein1912.However,organfunctionwasdiabetesandhypertensionasthecauseoffailurehasincreasedminimalandfurtherattem

6、ptsatorgantransplantationwerefrom24%to28%andthepercentageofglomerulardiseasehas2abandoned.However,intheearly1950s,Medawarandcol-declinedfrom42%to21%.Inaddition,theincidenceofleaguesdescribedthepreventionofrejectioninmiceandchronickidneydiseasehasalsorapidlyincreased,fr

7、om209,0003humanorgantransplantationwasagainattempted.Thefirstpatientsin1991to472,000in2004.CoreshandassociatessuccessfulrenaltransplantationwasperformedbyMurrayinhavenotedthatthehigherprevalenceofdiabetes,hypertension,1954betweenidenticaltwins.Othermajormilestonesintra

8、ns-andhigherbodymassindex(BMI)explainsthistrend.Simi-plantationhaveincludedthediscoveryofcyclosporineandlarly,thewait