March 1, 2002
Other
Question from Weyers Cave, Virginia, USA:
I have type�1 diabetes, and I am interested in a living liver donation, and I would like to know what additional risks diabetes would pose. I have read that people with diabetes can be organ donors (excluding the pancreas), but I can find no transplant programs allowing live donation. Does this apply only after death?
As I see it, if blood sugars are kept under control why couldn’t the otherwise healthy individual be a donor? The liver regenerates anyway. The risks include infection and death (17%). Would well-controlled diabetes significantly increase that risk? If the risks were increased by say, 5-10%, (on a case to case basis), diabetes still wouldn’t be enough reason to cut it off. Many people with diabetes are very healthy, very much more so then their peers because they take care of themselves. The long convalescence that would follow (that might hamper diabetes control in most individuals) would be possible to control in some dedicated individuals (with the help of an insulin pump and a good diabetes team). As for the surgery itself, the approximately 10 hour operation would not be a problem for one on the pump. With all the followup blood work, wouldn’t blood sugars be checked anyway?
Transplant programs are shooting themselves in the foot to make a blanket statement about not accepting people with diabetes as donors (liver). So many more lives could be saved if people with diabetes who are otherwise healthy were allowed to be donors. As an individual who has experienced the whole nine yards by people telling me I couldn’t give blood, bone marrow, or anything else on the sole basis of my diabetes, I proved them wrong. I am not going to let diabetes be the sole factor except in the case of very good reason — not on the perceived notion of people with diabetes as a whole, but rather based on the case-health of the individual. I know this doesn’t fall under any discrimination act. Is it hopeless to assume that I, as a person with type 1diabetes, would ever be considered as a donor?
Answer:
I applaud your desire to be a liver donor. I would suggest contacting someone from UNOS (United Network Organ Sharing) to get more specific information about criteria. I would tend to agree with you that persons with well-controlled diabetes may be able to donate liver. However, I think there is a global risk/benefit issue here. At multiple steps along the way, I would anticipate persons with diabetes having more difficulty.
JTL
Additional comments from Dr. Donough O’Brien:
I have no special knowledge of this subject myself, but I showed your question to our transplant immunology team, and they agreed that there was no special reason why you should not be accepted as a donor.
DOB
