Diabetes affects more than 220 million people worldwide, with the greatest number of cases in India, China and the United States. It can lead to life-threatening complications, but a double organ transplant can give some diabetics a new lease on life.
全世界有2亿2千万人被糖尿病所困扰，印度、中国和美国的糖尿病人最多。糖尿病可能导致危及生命的并发症。但是，一种双器官移植手术能让一些患者重获新生。
It's 5:30 a.m. in an operating room at Barnes-Jewish Hospital in St. Louis. Surgeon Jason Wellen points to his patient's open abdominal cavity, and her newly transplanted pancreas.
清晨5点30分，在圣路易斯巴恩斯犹太医院的一间手术室里，外科医生杰森·韦伦刚刚为蒂凡尼·布克塔做了胰脏移植手术。
"Here's the vein where the blood flows out, that we made a connection - you see the sutures right there?"
A light blue surgical sheet covers the rest of the patient's body and blocks the surgeon's view of her face. Her name is Tiffany Buchta. She has type 1 diabetes.
Early diagnosis
Before the surgery, Buchta - an administrator at a local community center - continued to work fulltime even when she was on dialysis.
She was diagnosed at 15. Formerly known as juvenile diabetes, the type 1 form develops when the body's immune system turns on itself, destroying the insulin-producing cells in the pancreas. About 10 percent of diabetics have this form of the disease.
布克塔是一名1型糖尿病患者，15岁那年就被诊断出有糖尿病了。1型糖尿病的形成是人体内的免疫系统出问题，破坏了胰脏内产生胰岛素的细胞。1型糖尿病患者占糖尿病患者人数的百分之10。
The exact cause of type 1 diabetes isn't known, but researchers believe a combination of genetics and environmental factors are to blame.
型糖尿病的发病原因还不为人所知，但是研究人员相信，祸首应该是遗传和环境因素的结合。
As a teenager, Buchta was an athlete, playing basketball for her high school. But after her diagnosis, life got a lot more complicated.
布克塔青少年时代是一名运动员，她念高中时，是篮球校队球员。可是患糖尿病后，她的生活就变得复杂了。
"Having a more strict schedule on when you eat, and taking your medicine, and weighing out your foods, and things like that," says Buchta. "It was kind of difficult at the beginning, but you just get used to it."
布克塔说：“进食时间，吃药时间，秤食物的重量，等等，都有严格规定。起初很难，但后来就习惯了。”
Unlike type 2 diabetics, who can often control their disease with diet, exercise, and oral medication, people with type 1 diabetes need daily insulin injections to survive. The disease can be particularly tough on the kidneys.
2型糖尿病患者往往可以靠饮食、运动和吃药来控制病情。可是1型糖尿病患者不同。他们每天都得靠注射胰岛素来维持生命。糖尿病可能对肾脏产生严重影响。
"Probably about three years ago, four years ago, I found out that my kidneys were like 45 percent functioning, and didn't realize that it could happen so quick."
布克塔说：“大约三、四年前，我的肾脏功能只剩下百分之45左右。当时没想到这个问题会发生得这么快。”
Kidney transplant
That was when she was in her early 30s. By October of last year, Buchta's kidneys had pretty much stopped working. Three times a week, she had to go to a local clinic. There, she spent three and a half hours hooked up to a dialysis machine. It filtered the waste products out of her blood, doing the job her kidneys no longer could.
那时，她才30岁出头。到去年10月，布克塔的两个肾脏都几乎完全失去功能。她必须每星期去诊所三次，花三个半小时做透析，把废物从血液中滤掉。
Then Buchta was offered the possibility of a transplant: not just a new kidney, but a pancreas, too.
后来，布克塔有了一个移植器官的机会：不仅换一个新肾，还要换一个新胰脏。
"If I was to just give a type 1 diabetic a kidney transplant, over time their diabetes is going to attack that kidney, just like it did their own kidneys," says Dr. Wellen. "So when you offer them a kidney and a pancreas transplant from the same donor, not only do you drastically improve their quality of life - so their sugar's completely normal, no longer need for insulin - but it makes that kidney last longer."
韦伦医生说：“如果我只给1型糖尿病患者换一个肾脏，过一段时间，糖尿病又会伤害那只新肾。所以，如果为他们移植来自同一名捐赠者的一个肾以及一个胰脏的话，就不但能明显改善他们的生活品质，使他们血糖完全正常，不再需要注射胰岛素，而且，也能使那个移植的肾维持更长时间。”
Buchta's transplanted pancreas and kidney are attached to blood vessels in her lower abdomen, leaving her own pancreas and kidneys in place. Her original pancreas still produces digestive enzymes, while her new pancreas makes the insulin she needs.
Her newly transplanted kidney will filter her blood and produce urine.
Hopeful future
With careful control of their blood glucose, cholesterol, and blood pressure, many type 1 diabetics can avoid serious complications. But for those who do develop renal failure, Wellen says a kidney-pancreas transplant can be life-saving.
许多1型糖尿病患者，可以通过小心控制血糖、胆固醇和血压，避免严重的并发症。韦伦医生说，但是对于已经出现肾功能衰竭的病人，肾脏和胰脏的双移植，可以挽救生命。
"If she did not get this transplant, Tiffany would have a 30 percent chance of living five years."
他说：“如果布克塔不做这个移植手术，她存活5年的机会，只有百分之30。”
With the pancreas and kidney of her donor - a 23-year-old car crash victim - Buchta is likely to live longer.
布克塔的新肾和胰脏来自一名23岁死于车祸的年轻人。靠着他的捐赠，布克塔可以活得更长了。
"This operation should give her a five year survival hopefully in the 85 percent range," says Wellen. "So you're going from a 30 percent chance of living five years to an 85 percent chance. I mean that's a big difference."
韦伦医生说：“这个手术应该使她有百分之85的机会可以存活5年。从百分之30到百分之85，这是很大的区别。”
Instead of insulin, Buchta will now need to take medications that suppress her immune system, to keep her body from rejecting her new organs. The drugs will also make her more vulnerable to infections and disease.
布克塔现在不需要注射胰岛素了，但需要服用抗排斥药，使她自己的身体不排斥她的新器官。这类药也会使她容易受到感染和患病。
But it's all worth it to Buchta. One month after the surgery, she's just happy to be off dialysis.
不过对布克塔来说，能够不再做透析，一切都值得。
"I mean I have so much more energy," she says. "And even with, you know, starting back to work, I was kind of scared on how, how much that would wear me out, but it really hasn't."
她说：“我现在精力充沛多了，甚至可以回去工作了。”
And as Buchta puts it, it's just nice to have her life back. |