ROCHESTER — A change in federal guidelines for living organ donation opens the door for people with well-controlled Type 2 diabetes to become kidney donors.

“I think this is a very significant shift in the eligibility criteria for living kidney donation in the U.S.,” said Dr. Naim Issa, a transplant nephrologist at Mayo Clinic in Rochester, the county’s second-largest living organ donor center. “In Europe, actually, diabetes was not completely (a) contraindication to donate a kidney.”

Before the Organ Procurement and Transplantation Network updated its policies in 2022, a potential living kidney donor would be disqualified if they were diagnosed with either Type 1 or Type 2 diabetes.

“Diabetes, especially if it’s poorly controlled, can lead to complications affecting our vital organs, especially the kidneys, the eyes, the heart,” Issa said. “And diabetes, in fact, is the leading cause of kidney disease in the U.S.”

But now, people with Type 2 diabetes could become kidney donors if they meet certain critera. (Type 1 diabetes is still excluded.)

Through Mayo Clinic, a potential kidney donor would be eligible if they don’t use insulin, are not overweight, don’t have a family history of kidney disease and go through a health assessment. Right now, those donors would also need to be at least 60 years old, Issa said.

“If you’re young with Type 2 diabetes … (you’ll) have another 20, 30 years to live, and we don’t know what will happen to their kidney function and to their vital organs,” Issa said.

Additionally, potential donors between the ages of 60 and 64 would need to not be on any medications for their diabetes. But, at age 65 and older, they can be taking up to two oral medications and still be eligible, according to the Mayo Clinic guidelines.

While Issa said he only expects a “handful” of living kidney donations per year from donors who meet the Type 2 diabetes critera, he said this type of donation can be helpful in certain situations, such as when a person wants to donate a kidney to their spouse.

Contributed / Mayo Clinic

“If a wife needs a kidney, they don’t have any potential donors, instead of staying on the waiting list for five to seven years,” Issa said, “Let’s say the husband is diabetic, but very well-controlled. (He’s) lean, maybe takes one medication, older than 65 and the diabetes did not affect any of the vital organs, the heart, the kidneys or the eyes.”

The expanded critera for living kidney donation comes at a time when, Issa said, the need for kidney transplants is increasing and the wait time for kidneys from deceased donors can last years for some patients.

“People are getting older, more diabetes and more obesity causing more and more kidney disease in this country — we have more than 90,000 people waiting for a kidney transplant,” Issa said. “This is mainly to address the increasing demand fo rkidneys and provide some people with a better chance for successful transplant and, of course, improve quality of life.”

Deceased donors with diabetes have been able to donate kidneys, Issa said, if their organs weren’t substantially harmed by their diabetes.