OUTCOMES OF KIDNEY TRANSPLANTATION FROM DECEASED DIABETIC DONORS: SINGLE CENTER STUDY.

Introduction:

Diabetes mellitus (DM) is an increasing comorbidity in the kidney donor population. Utilization of kidneys from donors with DM and subsequent recipient selection presents a challenge due to limited data on outcomes in this group. To address this gap, we investigated the outcomes of kidney transplantation from deceased diabetic donors over a 10-year period.

Methods:

We undertook a retrospective observational study of adult patients who underwent kidney alone transplantation from deceased donors at a single centre between 2012-2022. We stratified patients according to the diabetic status of both donor and recipient. We compared clinical characteristics of diabetic donors and recipients at the time of transplantation, and determined patient and allograft survival at 1-, 3- and 5-years post-transplant.

Results:

985 kidney transplant recipients (KTRs) were included, of whom 64 (6.5%) underwent transplantation from a diabetic donor. Diabetic donors were older, a higher proportion had hypertension, and they had a higher Kidney Donor Profile Index and implant Karpinski score. Recipients of diabetic donor kidneys were also older,  and had a higher baseline clinical frailty score. Creatinine levels at 1, 3, and 5 years were higher in KTRs of diabetic donors; rejection rates did not differ according to donor diabetes status. Patient and allograft survival were worst in diabetic recipients of diabetic kidneys (Figures A-C). Outcomes were similar in non-diabetic recipients regardless of the diabetic status of the donor. In multivariable analyses, recipient age (HR 1.05, 95% CI 1.03-1.08) and recipient diabetes (HR 2.22, 95% CI  1.32-3.67) increased the hazard of patient mortality but not death censored graft survival and donor diabetes had no effect on any recipient outcomes.

D-DN: Diabetic Donor

D-R: Diabetic recipient

ND-DN : Non-Diabetic Donor

ND-R: Non-diabetic Recipient

Conclusions:

Utilizing kidneys from diabetic donors is associated with acceptable recipient outcomes and offers a mechanism to expand the deceased donor pool. Recipient diabetes status should be considered during organ allocation.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.