AUTHOR=Li Shujing , Wang Yang , Chen Beike , Tang Maozhi , Zhang Keqin , Shen Linguo 

TITLE=Kidney transplantation with preformed diabetic nephropathy kidney: review of pathological changes and clinical outcomes

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1599660

DOI=10.3389/fendo.2025.1599660

ISSN=1664-2392

ABSTRACT=IntroductionKidney transplantation from expanded-criteria donors represents an effective approach to alleviate organ shortages. The feasibility for transplantation of donor kidneys with preformed diabetic nephropathy (DN) has not been extensively investigated.Search strategyWe performed a literature review to explore the pathological changes and clinical outcomes of kidney transplantation using preformed DN kidney. A systematic and comprehensive search was conducted from the inception to June 13, 2024.ResultsData from eight articles encompassing 103 cases were included for analysis. The pooled proportions of stable, progressive, and reversed DN-related pathological change were 0.66 (95% CI 0.56–0.77, I2 = 21.77%), 0.27 (95% CI 0.18–0.36, I2 = 10.04%) and 0.05 (95% CI 0.01–0.10, I2 = 0.00%), respectively. Eight-six cases were divided into post-transplant hyperglycemia group and normal post-transplant blood glucose group to evaluate the effect of post-transplant hyperglycemia on DN pathology, indicating the normal post-transplant blood glucose group had higher proportions of stable and reversed pathological states. Most cases achieved a graft survival rate of more than 80% at around five years post-transplant.ConclusionA majority of transplantations use donor kidneys with preformed DN exhibit acceptable renal pathological changes and graft survival. However, post-transplant hyperglycemia may adversely affect the pathological progression of the kidneys, particularly in cases with long-term follow-up.