The purpose of this study was to review published data on donor characteristics and the influence on preoperative Descemet membrane endothelial keratoplasty (DMEK) preparation and intraoperative graft manipulation.Methods: A systematic review of PubMed, EMBASE, OVID MEDLINE, and EBSCOhost was conducted up to April 2020. Studies were screened and predefined data criteria extracted. Eleven studies were found to meet the inclusion criteria.Results: Research regarding donor characteristics and the relationship to DMEK graft preparation and intraoperative graft manipulation was found to be limited because of the overall low-quality data. However, there was a trend of evidence supporting donor diabetes increasing the risk of graft tearing and consequent preparation failure and younger donors producing tighter scrolls complicating intraoperative graft unfolding.Conclusions: Further research into the area is warranted to better understand how donor characteristics impact preoperative DMEK graft preparation and intraoperative graft manipulation.