Outcomes of Deceased Donor Kidney Transplantation from Diabetic Donors: Does Presence of Recipient Diabetes Matter?

J. Rogers,¹ A. Farney,¹ G. Orlando,¹ A. Reeves-Daniel,² A. Palanisamy,² H. El-Hennawy,¹ M. Khan,¹ M. Gautreaux,¹ S. Iskandar,³ W. Doares,⁴ S. Kaczmorski,⁴ R. Stratta.¹

¹Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC
²Internal Medicine, WFBMC, Winston-Salem, NC
³Pathology, WFBMC, Winston-Salem, NC
⁴Pharmacy, WFBMC, Winston-Salem, NC.

Meeting: 2016 American Transplant Congress

Abstract number: B205

Keywords: Donors, Graft function, Graft survival, Kidney transplantation, marginal

Topic:

Session Information

Session Name: Poster Session B: Kidney Transplantation: KDPI, HCV/Matching, Donor Age

Date: Sunday, June 12, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Donor history of diabetes mellitus (DM) is a known risk factor for inferior graft survival after deceased donor kidney transplantation (DDKT) and is heavily weighted in the Kidney Donor Profile Index. The aim of this study was to determine the outcome of DDKT from diabetic donors into recipients with or without DM. Methods: Single center retrospective review of 1474 consecutive DDKT recipients from 1/1/02 – 11/3/14 who received T-cell depleting antibody induction and Tacrolimus/MPA/steroid maintenance immunosuppression. Results: Donor and recipient DM status were known in 1427 patients. 180 donors had DM (D-DM, 13%). 115 D-DM kidneys were transplanted into recipients without DM (R-NoDM, 64%) and 65 D-DM kidneys were transplanted into recipients with DM (R-DM, 36%). Mean follow-up was 4 years, minimum follow-up 1 year. R-DM were more likely to be African-American (54% R-DM, 34% R-NoDM, P=0.005) and have a higher BMI (29 kg/m²R-DM, 24 kg/m² R-NoDM, P<0.001). Donor and recipient age and gender, donor ethnicity, ECD status, presence of donor hypertension, HLA mismatch, PRA, preservation time, use of machine preservation, and DGF rates were comparable between R-NoDM and R-DM. Actuarial death-censored graft survival rates are shown below.

	1 year	3 years	5 years	7 years	P-Value
R-NoDM	90%	72%	67%	64%	P=0.02
R-DM	82%	67%	67%	48%	P=0.02

Biopsy proven acute rejection rates were comparable between groups (R-NoDM 9%, R-DM 15%, P=NS). One- and 2-year serum creatinine levels were lower in R-NoDM (1 year: R-NoDM 1.8 mg/dl, R-DM 2.2 mg/dl, P=0.04. 2 year: R-NoDM 1.7 mg/dl, R-DM 2.1 mg/dl, P=0.03). Conclusions: Non-diabetic recipients of diabetic donor kidneys have better early graft function and superior long-term graft survival compared to diabetic recipients. When possible and appropriate, diabetic donor kidneys should be preferentially allocated to non-diabetic recipients in order to optimize long-term outcomes.

CITATION INFORMATION: Rogers J, Farney A, Orlando G, Reeves-Daniel A, Palanisamy A, El-Hennawy H, Khan M, Gautreaux M, Iskandar S, Doares W, Kaczmorski S, Stratta R. Outcomes of Deceased Donor Kidney Transplantation from Diabetic Donors: Does Presence of Recipient Diabetes Matter? Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Rogers J, Farney A, Orlando G, Reeves-Daniel A, Palanisamy A, El-Hennawy H, Khan M, Gautreaux M, Iskandar S, Doares W, Kaczmorski S, Stratta R. Outcomes of Deceased Donor Kidney Transplantation from Diabetic Donors: Does Presence of Recipient Diabetes Matter? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-deceased-donor-kidney-transplantation-from-diabetic-donors-does-presence-of-recipient-diabetes-matter/. Accessed May 18, 2021.

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