Diabetes makes kidney transplants harder for end-stage renal disease patients in the USA. They face longer waits and poorer grafts. A large study quantifies survival gains from transplants. The results of the study were published in the BMJ Open Diabetes and Research Care.
Data Source and Patient Cohort
Researchers pulled data from the United Network for Organ Sharing file. It covered adults on the kidney waitlist from January 2014 to January 2024. They compared diabetic and non-diabetic patients for deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT).
Higher Risks on the Waitlist
Diabetic patients had 2.27 subdistribution HR (95% CI 2.23 to 2.32) for 10-year waitlist failure. They got worse DDKT grafts, with Kidney Donor Profile Index at 49% versus 35% (p<0.001). This shows clear disadvantages.
Survival Gains from DDKT
Transplants beat staying on the list for diabetics. DDKT gave 14.1 life-years from transplant. Over 10 years, it added 24% relative life-years gained via restricted mean survival.
LDKT Pulls Ahead in Benefits
LDKT offered 18.2 life-years from transplant for diabetics. It boosted 10-year gains by 29% versus remaining waitlisted (p<0.001). LDKT cut equal survival by 19 months and equal risk by 30 months compared to DDKT.
Call for Living Donor Focus
Both transplants extend life in diabetic ESRD. LDKT shines by shortening waits and improving grafts. Efforts must expand living donor options for this group.