부산대학교 도서관

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.