AUTHOR=Lee Kyo Won , Sim Jongmin , Park Sean S. W. , Jeon Junseok , Kim Gyuri , Kim Min Jung , Kwon Ghee Young , Jang Hye Ryoun , Huh Wooseong , Park Jae Berm 

TITLE=Recoverability of Diabetic Nephropathy of Donor Kidney After Kidney Transplantation

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10714

DOI=10.3389/ti.2022.10714

ISSN=1432-2277

ABSTRACT=Some kidney donors have diabetes, and little of their natural course of diabetic nephropathy (DN) is known. The aim of this study was to analyze the changes in pathologic lesions in the diabetic donor kidney after KT by performing protocol biopsy two weeks and one year after KT. This retrospective study included 103 patients who underwent KT, with kidneys from donors with a history of diabetes mellitus (DM). Among these, 37 underwent biopsy two weeks and one year after KT, of which, data of 34 patients were reviewed. Biopsy specimens were reviewed using light microscopy and electron microscopy. Glomerular basement membrane (GBM) thickness at two weeks and one year was compared. Biopsy showed that DN occurred in 29 of the 34 patients. However, 17 of them (50%) were classified as having class I, a mild case with an increase in GBM thickness. Only trivial histological changes were observed in 22 patients (64.7%), including 5 patients who did not show DN. At one year after transplantation, there was no change in the DN histologic class in 26 patients (76.5%), and there was no statistically significant difference in the change in GBM thickness. This pattern was observed regardless of the recipient’s DM or glycemic control. Donor DN was mostly stable for one year after KT, and this pattern did not depend on the recipient’s DM or glycemic control status. With this understanding, clinicians can use kidneys from DM donors with more comfort, thereby reducing the kidney discard rate.