An individual with diabetes can often become an organ donor, but eligibility is a specific medical determination. The presence of diabetes alone does not automatically disqualify someone from donating their organs, tissues, or eyes. The decision hinges on the overall health and function of the organs at the time of donation, which is assessed through rigorous testing. The primary concern is whether the organs have sustained damage from diabetes, a condition that can impair the body’s blood vessels and nerves over time.
Deceased Donor Eligibility
The criteria for deceased organ donation are generally less restrictive than those for living donation, focusing on the immediate condition of the organs. The transplant team quickly evaluates each organ for signs of damage before it is considered for transplant. Both Type 1 and Type 2 diabetic individuals are considered potential donors after death.
The fundamental legal framework governing this process in the United States is the Uniform Anatomical Gift Act (UAGA). While a diabetes diagnosis does not preclude donation, severe diabetes-related complications such as advanced heart disease or extensive kidney failure would render those specific organs unusable. Organs from diabetic donors, particularly kidneys, are increasingly being utilized due to the growing need for transplants.
Living Donor Eligibility
The standards for living organ donation are significantly more stringent because the evaluation must protect the long-term health of the donor. Diabetes is a major cause of kidney failure, and removing one of a diabetic person’s two healthy kidneys substantially increases their risk of developing end-stage renal disease. For this reason, Type 1 diabetes is considered an absolute exclusion for living kidney donation due to the high risk of future complications.
National policy has recently been updated, allowing some individuals with Type 2 diabetes to be evaluated as potential living donors under specific circumstances. These candidates must undergo a rigorous screening process to ensure there is no evidence of existing organ damage. Screening includes specialized checks, such as an oral glucose tolerance test and microalbuminuria checks, to assess kidney function and detect early signs of vascular damage. Only older individuals, often over the age of 60, with very well-controlled, non-insulin-dependent Type 2 diabetes are typically considered.
Key Factors Determining Organ Suitability
The viability of any organ from a diabetic donor is determined by specific medical factors that indicate the extent of diabetes-related microvascular damage. A longer duration of diabetes increases the likelihood of long-term damage to the organ’s delicate blood vessels. Transplant teams also scrutinize the donor’s history of glycemic control, reflected by the hemoglobin A1c (HbA1c) level.
The HbA1c test measures the average amount of glucose attached to the red blood cells over the preceding two to three months. A consistently high HbA1c level indicates poor glucose control, which accelerates damage to organs like the heart, kidneys, and liver. The evaluation also focuses on co-morbidities, such as high blood pressure (hypertension) or high cholesterol (hyperlipidemia), which compromise organ health. Specific organ assessments, including echocardiograms and sophisticated imaging, are used to evaluate the organ’s current condition before transplantation is approved.
The Final Decision and Recipient Risk Assessment
The final stage involves a detailed risk-benefit analysis conducted by the transplant center and the recipient. Organs from diabetic donors are sometimes viewed as having a higher potential risk for long-term complications or a slightly reduced lifespan compared to organs from non-diabetic donors. The United Network for Organ Sharing (UNOS) provides guidelines for matching, but the ultimate decision rests with the recipient and their medical team.
Recipients must be fully informed that they are receiving an organ from a donor with a history of diabetes. If a recipient is critically ill, or if a suitable non-diabetic organ is not immediately available, they may choose to accept the organ to avoid a longer wait. This choice balances the certainty of a poor outcome without a transplant against the possibility of a successful, potentially shorter, life with the donated organ.