【Introduction】The shortage of kidney donor has limited the treatment of patients with end-stage kidney disease. To use diabetic donor with normal renal function is would be one of solutions for limited donor pool in deceased kidney transplantation (KTX). However, diabetic donors sometimes have pathological deterioration indicating diabetic nephropathy (DMN) at donation, which has been considered to be irreversible. The aims of this study are to evaluate the feasibility of diabetic donor with DMN and the histological change of DMN after KTX in non-diabetic recipients.

【Patients and Methods】Five non-diabetic kidney recipients evaluated by oral glucose tolerance test (OGTT) were enrolled in this study (Mean age 48.6; Gender M/F, 1/4). These patients underwent KTX from diabetic deceased donor with biopsy proven DMN with normal renal function. The recipients were maintained with tacrolimus, mycophenolate mofetil, methylprednisolone for more than 3 years. We performed protocol biopsy annually and assessed the histological change of DMN over time. Histological DMN was scored by grade of glomerular lesion as follows:0, no findings; I, mild light microscopy change; IIa, mild mesangial expansion (ME); IIb, severe ME.

【Results】The mean follow-up period is 4.6 year. Their HbA1c level was maintained normal range and OGTT showed non-diabetic pattern in all recipients. All allograft is surviving with excellent renal function (Mean eGFR 56.7 ml/min). Histological amelioration of DMN was observed in one patient one year after KTX. Interestingly the histological amelioration was eventually observed in three patients three years after KTX. Importantly, there is no patient whose DMN lesion is deteriorated.

【Conclusion】KTX from diabetic donor with normal function is feasible and could be an option to expand the donor pool. In addition, the histological DMN lesion from diabetic donor is reversible when the allograft is transplanted to non-diabetic recipient.

CITATION INFORMATION: Hotta K., Iwami D., Harada H., Fukasawa Y., Okada H., Higuchi H., Hirose T., Fukuzawa N., Shinohara N. Pre-Existing Allograft Diabetic Nephropathy from Diabetic Donor is Reversible after Kidney Transplantation in Non-Diabetic Recipient Am J Transplant. 2017;17 (suppl 3).

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