死戦期HbA1c高値ドナーからの腎移植後膵移植の1例

坂本 扶美枝; 黒田 暁生; 川嶋 聡; 加藤 研; 植田 江梨子; 高原 充佳; 宮下 和幸; 嵩 龍一; 安田 哲行; 松岡 孝昭; 種村 匡弘; 伊藤 壽記; 高原 史郎; 山崎 義光; 松久 宗英; 金藤 秀明; 下村 伊一郎

doi:10.11213/tonyobyo.54.417

Case Reports

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

Fumie Sakamoto, Akio Kuroda, Satoshi Kawashima, Ken Kato, Eriko Ueda, Mitsuyoshi Takahara, Kazuyuki Miyashita, Ryuichi Kasami, Tetsuyuki Yasuda, Taka-aki Matsuoka, Masahiro Tanemura, Toshinori Ito, Shiro Takahara, Yoshimitsu Yamasaki, Munehide Matsuhisa, Hideaki Kaneto, Iichiro Shimomura

Author information

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

JOURNAL FREE ACCESS

2011 Volume 54 Issue 6 Pages 417-424

DOI https://doi.org/10.11213/tonyobyo.54.417

Details

Abstract

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.

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