title: Histological reversibility of diabetic nephropathy after kidney transplantation from diabetic donor to non-diabetic recipient.
abstract: OBJECTIVE
  Given the recent increase in the prevalence of diabetes mellitus, it is not uncommon for kidney transplantation donors to have diabetes. We perform kidney transplantation in our hospital if the diabetic donors are receiving oral hypoglycaemic agents, but not insulin, and their haemoglobin A1C (HbA1C) is below 6.5%. There are few reports about histological changes to diabetic nephropathy after transplantation of kidney grafts from donors with diabetes mellitus to non-diabetic recipients. Therefore, we studied the histological diabetic changes in grafts from diabetic donors at protocol biopsies (1 hour, 1 month, 1 year), and evaluated whether they improved under the recipient's good glycaemic control.
  
  
  METHODS
  Three cases of kidney transplantation from donors with diabetes mellitus to non-diabetic recipients were selected. We used a pathological classification established by the Renal Pathology Society for evaluating histological improvements in diabetic nephropathy.
  
  
  RESULTS
  The results revealed that early diabetic changes found at the 1-hour and 1-month protocol biopsies were reversed and improved at the 1-year biopsy.
  
  
  CONCLUSIONS
  We concluded that early diabetic changes in grafts from diabetic donors may improve if the graft recipient has good glycaemic control after kidney transplantation.
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Shumpei
authors.initials: S
authors.lastname: Harada
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ushigome
authors.affiliation: Department of Clinical Pathology, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nishimura
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Nakao
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Koshino
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Nobori
authors.affiliation: Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto-prefecture, 602-8566, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D064591:Allografts; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D003928:Diabetic Nephropathies / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D046148:Donor Selection; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012074:Remission Induction; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: Diabetic nephropathy; donor; kidney transplantation; reversibility