Abouna G M, Al-Adnani M S, Kremer G D, Kumar S A, Daddah S K, Kusma G
Lancet. 1983 Dec 3;2(8362):1274-6. doi: 10.1016/s0140-6736(83)91151-0.
Two kidneys were removed from a cadaveric donor with 17-year history of type 1 diabetes. At the time of death the donor had proteinuria but normal serum creatinine, and on histological examination the kidneys showed features of established diabetic nephropathy including diffuse glomerulosclerosis and thickening of mesangial matrix and capillary basement membranes. After transplantation into non-diabetic recipients (cold ischaemia times 46 h and 52 h) the kidneys functioned well with standard immunosuppression. Renal biopsy specimens taken 7 months after transplantation showed almost complete resolution of the nephropathy and both patients remain free from proteinuria after a further 7 months. As well as indicating that longstanding type 1 diabetes need not always contraindicate kidney donation, these observations are relevant to the pathogenesis and management of diabetic nephropathy.
从一名患有17年1型糖尿病病史的尸体供体身上取出了两个肾脏。供体死亡时存在蛋白尿，但血清肌酐正常，组织学检查显示肾脏具有已确诊的糖尿病肾病特征，包括弥漫性肾小球硬化以及系膜基质和毛细血管基底膜增厚。移植到非糖尿病受体后（冷缺血时间分别为46小时和52小时），在标准免疫抑制情况下肾脏功能良好。移植后7个月获取的肾活检标本显示肾病几乎完全消退，且两名患者在接下来的7个月里均未出现蛋白尿。这些观察结果不仅表明长期的1型糖尿病不一定总是肾脏捐赠的禁忌证，还与糖尿病肾病的发病机制和管理相关。
