Development of IDDM after donating kidney to diabetic sibling.
The goal of this study was to describe a patient who developed insulin-dependent diabetes mellitus (IDDM) after donating a kidney to his sibling and to suggest a possible solution to prevent such an occurrence. A 42-yr-old man was found to have islet cell autoantibodies (ICAs) as part of a screening program of first-degree relatives with IDDM. Two years previously, he had donated his kidney to his HLA-identical sibling with long-standing IDDM. Both oral and intravenous glucose tolerance tests demonstrated a gradual loss of insulin secretion and increasing glucose intolerance until the patient developed IDDM 6 yr after the nephrectomy. Whether the presence of ICA is an absolute contraindication to being a kidney donor could be debated. Nonetheless, ICA should be used as a screening test to identify individuals at risk for subsequent IDDM. For those found to be positive, counseling should be provided.
Riley
W J
WJ
Department of Pathology and Laboratory Medicine, University of Florida, Gainesville.
Maclaren
N K
NK
Spillar
R P
RP
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D000075202:Contraindications; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008403:Mass Screening / Q000379:methods; D012801:Sibling Relations; D014019:Tissue Donors
D001323:Autoantibodies; C024211:islet cell antibody