Pancreas after Kidney Transplant from Donor with Elevated Agonal HbA1c: A Case Report

  • Sakamoto Fumie
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Kuroda Akio
    Diabetes Clinical Research and Development Center, Tokushima University
  • Kawashima Satoshi
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Kato Ken
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Ueda Eriko
    Transplantation Service, Osaka University Graduate School of Medicine
  • Takahara Mitsuyoshi
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Miyashita Kazuyuki
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Kasami Ryuichi
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Yasuda Tetsuyuki
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Matsuoka Taka-aki
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Tanemura Masahiro
    Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine
  • Ito Toshinori
    Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine Department of Complementary and Alternative Medicine, Osaka University Graduate School of Medicine
  • Takahara Shiro
    Department of Urology, Osaka University Graduate School of Medicine
  • Yamasaki Yoshimitsu
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Matsuhisa Munehide
    Diabetes Clinical Research and Development Center, Tokushima University
  • Kaneto Hideaki
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine
  • Shimomura Iichiro
    Department of Metabolic Medicine, Osaka University Graduate School of Medicine

Bibliographic Information

Other Title
  • 死戦期HbA1c高値ドナーからの腎移植後膵移植の1例
  • 症例報告 死戦期HbA1c高値ドナーからの腎移植後膵移植の1例
  • ショウレイ ホウコク シセンキ HbA1c コウチ ドナー カラ ノ ジンイショク ゴスイイショク ノ 1レイ

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Description

Pancreas transplantation in Japan ostensibly requires that the donor have “no history of diabetes.” We report a case in which, following a kidney transplant, the subject had a pancreas transplanted from a donor suspected of being glucose-intolerant and became insulin-independent postoperatively. A man in his 30's developing Type 1 diabetes mellitus in 1982, undergoing hemodialysis for end-stage renal disease in 2004 and a living-donor kidney transplant from his mother in September 2005. The pancreas was transplanted from a cerebral-infarction-induced brain-dead donor on April 5, 2008. The donor had never been diagnosed with diabetes mellitus but had HbA1c of 7.3% at brain death. Despite daily 60-unit insulin dosage before transplant, the subject became insulin-independent and has had undeteriorated renal function for more than one year since the transplant. Postoperative pancreas graft function results in Japan are comparable to those in Europe and North America, and the problem of the almost complete lack of donors remains. This case thus shows the possibility of making pancreas transplant donor criteria more flexible.<br>

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