Kidney Week

Abstract: SA-PO953

Outcomes of Kidney Transplantation from Deceased Diabetic Donors

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Emara, Ahmed, Ain Shams University Faculty of Medicine, Cairo, Egypt

Ahmed Emara, MD

• Hobill, Abigail, Royal Free London NHS Foundation Trust, London, United Kingdom

Abigail Hobill, MSc

• Nagpal, Ria, Royal Free London NHS Foundation Trust, London, United Kingdom

Ria Nagpal, MBBS

• Karst, Felix Wilhelm, Royal Free London NHS Foundation Trust, London, United Kingdom

Felix Wilhelm Karst, MD

• Khan, Azhar Ali, Royal Free London NHS Foundation Trust, London, United Kingdom

Azhar Ali Khan

• Javed, Maryam, Royal Free London NHS Foundation Trust, London, United Kingdom

Maryam Javed, MBBS

• Gage, Alice M., Royal Free London NHS Foundation Trust, London, United Kingdom

Alice M. Gage, MBChB

• Needleman, Amy, Royal Free London NHS Foundation Trust, London, United Kingdom

Amy Needleman, MBBS

• Fernando, Raymond, Royal Free London NHS Foundation Trust, London, United Kingdom

Raymond Fernando, PhD

• Jones, Gareth L., Royal Free London NHS Foundation Trust, London, United Kingdom

Gareth L. Jones, MBBS, PhD

• Evans, Rhys, University College London, London, United Kingdom

Rhys Evans, MA, MBBS, PhD

Background

Diabetes mellitus (DM) is an increasing comorbidity in the kidney donor population. Utilization of kidneys from donors with DM and subsequent recipient selection is challenging 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 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.

Conclusion

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

(A) Patient survival, (B) Allograft survival (C) Allograft survival censored for patient death stratified by donor and recipient diabetes status.

D-DN: Diabetic Donor
D-R: Diabetic recipient
ND-DN : Non-Diabetic Donor
ND-R: Non-diabetic Recipient