A Technique for the Transplantation of 2 Adult Cadaver Kidney Grafts Into 1 Recipient

Masson, Douglas; Hefty, Thomas R.

doi:10.1016/s0022-5347(01)62406-6

Cited by 33 publications

(12 citation statements)

References 2 publications

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“…The unilateral placement of two grafts extraperitoneally through a single Gibson incision (U-DKT) was introduced by Masson and Hefty in 1998 (19). Our surgical technique is much the same, differing only in our use of external iliac vessels for the anastomosis of both kidneys, extending the right renal vein with a segment of the donor's IVC, and implanting the ureters separately according to the Lich-Gregoir technique, with a double-J stent for each ureter (20).…”

Section: Discussionmentioning

confidence: 99%

A single‐center experience with 200 dual kidney transplantations

Rigotti

Capovilla

Bella

et al. 2014

Clinical Transplantation

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This study reports on a large series of 200 dual kidney transplantations (DKTs) from expanded criteria donors (ECDs) and proposes specific ways to optimize outcomes. Data concerning 200 DKTs performed in the last 14 yr were retrospectively analyzed. Kidneys from high-risk ECD were allocated for use in DKTs on an old-for-old basis after histological assessment. Different surgical techniques and immunosuppressant regimens were used over time, and the outcomes are discussed. Donors and recipients were a median 73 (70-77) and a 62 (58-67) yr old, respectively. Delayed graft function occurred in 31.5% of cases, and acute rejection in 13.5%. Patient and graft survival at five yr were 90.4% and 85.8%, respectively. Unilateral kidney placement was preferred for 75% of patients, and was associated with a low rate of surgical complications. Our current standard therapy comprising low-dose calcineurin inhibitors (CNIs) associated with mammalian target of rapamycin inhibitors (mTOR) and steroids appears to offer the best risk/benefit profile for elderly patients undergoing DKT. In our experience, outcomes after DKT can be improved by: (i) kidney clinical-histological assessment; (ii) unilateral kidney placement; (iii) minimal use of CNI associated with mTOR.

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Section: Discussionmentioning

confidence: 99%

A single‐center experience with 200 dual kidney transplantations

Rigotti

Capovilla

Bella

et al. 2014

Clinical Transplantation

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“…Since the first DKT was reported in 1996 [9], many centers now perform DKT using different organ selection criteria and surgical techniques [4,7,10–12], including the bilateral placement of both kidneys, intra‐ or extra‐peritoneally [9], through two separate Gibson incisions or one midline incision [3], and the monolateral placement of both kidneys extraperitoneally through a single Gibson incision [13]. The issue of which surgical technique to use for this procedure is very relevant because the potential disadvantages of DKT include a longer operating time and greater surgical risk.…”

Section: Introductionmentioning

confidence: 99%

Monolateral placement of both kidneys in dual kidney transplantation: low surgical complication rate and short operating time*

et al. 2006

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Summary Dual kidney transplantation (DKT) from marginal donors is increasingly used at many centers to help cope with the organ shortage problem. The disadvantages of DKT consist in longer operating times and the risk of surgical complications. DKT can be performed in two ways, i.e. using monolateral or bilateral procedures. From October 1999 to June 2005, 58 DKTs were performed at our unit. In 29 cases (group I), the kidneys were extraperitoneally placed bilaterally in the iliac fossae via two separate incisions; as of June 2003, monolateral kidney placement was preferred in 29 cases, whenever compatible with the recipient's morphological status (group II). After a mean follow‐up of 51 ± 19 months for group I and 15 ± 7 months for group II, all patients are alive with 1‐year graft survival rates of 93% and 96%, respectively. Mean operating times were 351 ± 76 min in group I and 261 ± 31 min in group II (P = 0.0001). The mean S‐creatinine levels in groups I and II were 132 ± 47 and 119 ± 36 μmol/l, respectively, at 1 year. We observed eight surgical complications in group I and seven in group II. Both techniques proved safe, with no differences in surgical complication rates. The monolateral procedure has the advantage of a shorter operating time and the contralateral iliac fossa remains available for further retransplantation procedures.

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“…[ 4 ] Unilateral placement of both kidneys was described by Mason and Hefty in 1998. [ 5 ] The right kidney was placed superiorly, with renal artery anastomosed into the common iliac artery and renal vein into the inferior vena cava. With this method, both ureters were spatulated and joined to each other.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] Later on, surgical modifications such as unilateral placement of the kidney and en bloc transplantation had been described. [ 4 5 6 7 ] In the past few years, robotic kidney transplantation is gaining popularity across the world. [ 8 9 ] The first case of robotic-assisted DKT was reported by Frongia et al .…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted dual kidney transplantation

et al. 2018

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Aim:The aim of this study was to report the feasibility of robotic-assisted dual kidney transplantation (DKT) in a marginal donor.Materials and Methods:The case was a 53-year-old male, who with IgA nephropathy underwent a robotic-assisted robotic DKT.Results:The total operating time was 265 min, total console time was 215 min, and anastomotic time was 39 min for both the kidneys, and blood loss was 220 ml. The total drain output was 150 ml on the 1st day. The drain was removed after 48 h and Foley catheter was removed after 5 days. Nadir creatinine was 1.1 mg/dl and time to nadir creatinine was 7 days. The patient received one unit of blood transfusion. Total postoperative hospital stay was 7 days and bilateral ureteric stents were removed after 14 days. At the end of 3 months, creatinine was 1.0 mg% and epidermal growth factor receptor was 82 ml/min/1.73 m2.Conclusion:Robotic DKT offers solutions to the challenges faced in open DKT.

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A Technique for the Transplantation of 2 Adult Cadaver Kidney Grafts Into 1 Recipient

Cited by 33 publications

References 2 publications

A single‐center experience with 200 dual kidney transplantations

A single‐center experience with 200 dual kidney transplantations

Monolateral placement of both kidneys in dual kidney transplantation: low surgical complication rate and short operating time*

Robotic-assisted dual kidney transplantation

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