Development of IDDM after donating kidney to diabetic sibling.
 The goal of this study was to describe a patient who developed insulin-dependent diabetes mellitus (IDDM) after donating a kidney to his sibling and to 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 screening program 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.
