Development of IDDM After Donating Kidney to Diabetic Sibling
- William J Riley, MD,
- Noel K Madaren, MD and
- Rebecca P Spillar, MA
- Departments of Pathology and Laboratory Medicine and Pediatrics, University of Florida Gainesville, Florida
- Address correspondence and reprint requests to William J. Riley, MD, Department of Pathology and Laboratory Medicine, Box J-275, J.H.M.H.C, Gainesville, FL 32610–0275.
Abstract
The goal of this study was to describe a patient who developed insulin-dependent diabetes mellitus (IDDM) after donating a kidney to his sibling andto 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 screeningprogram 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.
- Received December 12, 1989.
- Revision received March 21, 1990.
- Accepted March 21, 1990.
- Copyright © 1990 by the American Diabetes Association
