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Diabetic kidneys can safely expand the donor pool
Yolanda T Becker1, Glen E Leverson, Anthony M D'Alessandro
1Division of Transplantation, Department of Surgery, University of Wisconsin, Madison 53792, USA. yolanda@tx.surgery.wisc.edu
Transplantation
|July 23, 2002
Summary
Kidneys from donors with diabetes mellitus (type 1 or type 2) can be safely transplanted, showing similar long-term survival rates. However, recipients may face increased risks of proteinuria and post-transplant glucose intolerance.
Area of Science:
- Nephrology
- Transplantation Immunology
- Diabetology
Background:
- Increasing organ demand necessitates using kidneys from medically marginal donors, including those with diabetes.
- Diabetic donor kidneys are being considered more frequently for renal transplantation.
Purpose of the Study:
- To compare transplant outcomes using kidneys from donors with type 1 diabetes mellitus (D1) or type 2 diabetes mellitus (D2).
- To evaluate the safety and efficacy of diabetic donor kidney transplantation.
Main Methods:
- Retrospective analysis of 2013 renal transplant recipients.
- Comparison of outcomes between recipients of D1, D2, and non-diabetic donor (D0) kidneys.
- Assessment of graft function, proteinuria, rejection episodes, and patient/graft survival.
Main Results:
- Kidneys from donors with type 2 diabetes mellitus (D2) originated from older donors.
- Recipients of D2 kidneys showed higher mean discharge serum creatinine and increased post-transplant proteinuria.
- While not statistically significant, recipients of diabetic kidneys were more likely to require oral hypoglycemic therapy post-transplant.
- No significant differences in rejection episodes, long-term graft survival, or patient survival were observed among groups.
Conclusions:
- Diabetic donor kidneys can be safely utilized for transplantation without compromising patient or graft survival.
- Pre-existing diabetic nephropathy in donors may elevate risks for proteinuria, impaired renal function, and post-transplant glucose intolerance in recipients.