Combined 'En Bloc' Liver And Pancreas Transplantation In Patient With Hepatocellular Carcinoma And Type 2 Diabetes Mellitus

Objective To investigate the clinical efficacy of liver-duodeno-pancreatic organ cluster transplantation in patients with upper abdominal malignancy and those with hepatocellular carcinoma and type 2 diabetes.Method The clinical data of 4 cases of liver-duodenc-pancreatic organ cluster transplantation in patients with hepatocellular carcinoma and type 2 diabetes were retrospectively analyzed.They suffered from hepatocellular carcinoma and type 2 diabetes.The pancreas and the whole digestive tract of the recipients were reserved.The liver and pancreas duodenal organ cluster grafts were implanted after the resection of the lesion liver.Result From one to seven days after operations,no insulin was used in all the patients,the blood glucose levels returned to the almost normal level.Alanine aminotransferase (ALT) and total bilirubin became normal after 1 week.C-peptide was increased posttransplantation.Levels of HbA1C were decreased significantly 3 months posttransplantation and remained low.One died of acute monocytic leukemia,one suffered from pulmonary infection,one suffered from intestinal fistula which was came from pancreatic leakage,and no obvious complications were observed in the remaining patients.So far of the follow-up to the last follow-up,the longest survival time was was more than 14 months,liver and pancreatic grafts functioned well,and quality of life in patients was satisfactory.Conclusion Patients with hepatocellular carcinoma and type 2 diabetes may be one of the indications for combined en bloc' liver and pancreas transplantation.Liver-duodeno-pancreatic organ cluster transplantation is technically feasible and an effective method for the treatment of hepatocellular carcinoma with type 2 diabetes.