Liver grafts from donors with a history of diabetes mellitus (DM) have been associated with reduced graft survival after liver transplantation. Transplantation centers are often reluctant to accept a liver from a donation after circulatory death (DCD) donor with increased risk factors, such as DM, since DCD liver grafts are vulnerable. It has, however, not been investigated whether livers from diabetic donors are associated with worse graft survival in DCD liver transplantation.

Seventy liver transplant recipients of diabetic donors from all three transplantation centers in the Netherlands between 2006-2016 were included. This cohort was matched with 70 recipients of livers from non-diabetic donors based on BAR-score, adding up to 140 patients. Both donation after brain death (DBD) and DCD procedures, were included. Exclusion criteria were recipient age <18 years, split liver grafts, and combined transplantation. Kaplan-Meijer survival and log-rank tests were used to study the effect of donor diabetes on 1-year graft survival.

Donor DM was associated with lower 1-year graft survival, compared to transplantation with non-DM donors (82.9% vs. 85.7%). In DBD transplantation (n=114), this difference was more pronounced with a survival rate of 89.5% for non-DM donors versus 82.5% for donors with DM (p=0.28) . In DCD donation however, donors with a history of DM (n=11) were associated with higher 1-year graft survival compared to donors without DM (n=13) (100% vs. 69.2% respectively, p=0.005) .

It is safe to use livers from diabetic donors in the setting of DCD transplantation. In this study, grafts from donors with DM were even associated with higher 1-year graft survival compared to non-DM donors.

CITATION INFORMATION: Brüggenwirth I., Vasiliauskaire I., Westerkamp A., Polak W., Braat A., Porte R. Livers from Diabetic Donors Can Safely Be Used in Donation after Circulatory Death Liver Transplantation Am J Transplant. 2017;17 (suppl 3).

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