Dual Kidney Transplantation: A Single-Center Experience in Thailand

Arpornsujaritkun, Nuttapon; Jirasiritham, S.; Pootracool, Piyanut; Tirapanich, Wiwat; Gesprasert, Goragoch; Sakulchairungrueng, Bundit; Wiwattanathum, Punlop; Leelaudomlipi, Surasak; Sriphojanart, Suthus

doi:10.1016/j.transproceed.2018.03.060

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…Multiple studies of short and long-term success with adult DKT have been reported since the early 2000s (Table 3 cites literature since 2015) [64–82,83 ▪▪ ,84]. Many of these studies focused on identifying appropriate selection criteria for DKT including not only prerecovery but also postrecovery (anatomy, histopathology, and preservation) factors.…”

Section: History Of Dual Kidney Transplantationmentioning

confidence: 99%

“…Centers in France, Germany, and the United Kingdom have likewise provided important contributions to the world experience in DKT including the use of alternative scoring systems and expansion with DCD donor kidneys [36,37,51,52,60,64,65,77,79,83 ▪▪ ]. In addition, centers in Ireland, Canada, Australia, Czech Republic, the Middle East, and Asia have reported valuable experiences with DKT [38,70,71,78,80–82,86].…”

Section: The International Experience With Dual Kidney Transplantationmentioning

confidence: 99%

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The use of marginal kidneys in dual kidney transplantation to expand kidney graft utilization

Stratta

Harriman

Gurram

et al. 2021

Current Opinion in Organ Transplantation

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Purpose of reviewThe purpose of this review is to chronicle the history of dual kidney transplantation (DKT) and identify opportunities to improve utilization of marginal deceased donor (MDD) kidneys through DKT. Recent findingsThe practice of DKT from adult MDDs dates back to the mid-1990s, at which time the primary indication was projected insufficient nephron mass from older donors. Multiple subsequent studies of short-and longterm success have been reported focusing on three major aspects: Identifying appropriate selection criteria/scoring systems based on pre-and postdonation factors; refining technical aspects; and analyzing longer-term outcomes. The number of adult DKTs performed in the United States has declined in the past decade and only about 60 are performed annually. For adult deceased donor kidneys meeting double allocation criteria, >60% are ultimately not transplanted. MDDs with limited renal functional capacity represent a large proportion of potential kidneys doomed to either discard or nonrecovery. SummaryDKT may reduce organ discard and optimize the use of kidneys from MDDs. New and innovative technologies targeting ex vivo organ assessment, repair, and regeneration may have a major impact on the decision whether or not to use recovered kidneys for single or DKT.

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Section: History Of Dual Kidney Transplantationmentioning

confidence: 99%

Section: The International Experience With Dual Kidney Transplantationmentioning

confidence: 99%

The use of marginal kidneys in dual kidney transplantation to expand kidney graft utilization

Stratta

Harriman

Gurram

et al. 2021

Current Opinion in Organ Transplantation

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“…DDs with marginal renal functional capacity represent a large proportion of potential kidneys doomed to discard or non‐recovery 7,10,11,33,110,148–175 . One approach to offset this dilemma has been the greater application of DKT from adult MDDs 35–145 . There have been several excellent recent reviews focusing on various aspects of DKT 72,118,127,129,130,138,142 .…”

Section: Introductionmentioning

confidence: 99%

“…Due to the burgeoning crisis between organ supply and demand, national initiatives such as the Organ Donor Breakthrough Collaborative were created in order to expand the size of the DD pool 14,15 . These efforts resulted in an upturn in the number of “marginal” DDs (MDDs) such as expanded criteria donors (ECDs), 16–21 donation after cardio‐circulatory death (DCD) donors, 22–24 standard criteria donors (SCDs) with prolonged warm or cold ischemia times (CIT), 25–28 acute kidney injury donors, 29–34 and dual kidney transplants (DKT) from donors at the extremes of age 35–145 . These latter references cited represent the majority of the world literature to date on DKT from adult MDDs and are listed in chronological order by year of publication.…”

Section: Introductionmentioning

confidence: 99%

“…Centers in France, Germany, and the United Kingdom have likewise provided important contributions to the world experience in DKT including the use of alternative scoring systems and expansion with DCD donor kidneys 51,65,81,82,84,96,113–115,117,118,125,127,135,144 . In addition, centers in Ireland, Canada, Australia, Czech Republic, the Middle East, and Asia have reported valuable experiences with DKT 85,91,101,105,107,116,128–130,137,139–141,143 …”

Section: Introductionmentioning

confidence: 99%

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Dual kidney transplants from adult marginal donors: Review and perspective

Stratta

Harriman

Gurram

et al. 2022

Clinical Transplantation

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The practice of dual kidney transplantation (DKT) from adult marginal deceased donors (MDDs) dates back to the mid-1990s with initial pioneering experiences reported by the Stanford and Maryland groups, at which time the primary indication was estimated insufficient nephron mass from older donors. Multiple subsequent studies of short and long-term success have been reported focusing on three major aspects of DKT: Identifying appropriate selection criteria and developing scoring systems based on pre-and post-donation factors; refining technical aspects; and analyzing mid-term outcomes. The number of adult DKTs performed in the United States has declined in the past decade and only about 60 are performed annually. For adult deceased donor kidneys meeting double allocation criteria, > 60% are ultimately not transplanted. Deceased donors with limited renal functional capacity represent a large proportion of potential kidneys doomed to either discard or non-recovery. However, DKT may reduce organ discard and optimize the use of kidneys from MDDs. In an attempt to promote utilization of MDD kidneys, the United Network for Organ Sharing introduced new allocation guidelines pursuant to DKT in 2019. The purpose of this review is to chronicle the history of DKT and identify opportunities to improve utilization of MDD kidneys through DKT. K E Y W O R D Sdual kidney transplants, index, kidney discard, kidney donor profile marginal deceased donors, nephron mass INTRODUCTIONFor patients with end stage renal disease (ESRD), kidney transplantation is associated with extended life expectancy, improved quality of life, and has proven to be cost-effective long-term compared to any type of dialysis. 1-6 As of August 2021, the United Network for Organ Sharing (UNOS) national waiting list for solid organ transplantation had nearly 107 000 total candidates, including > 90 000 patients (84.6%) awaiting kidney transplantation. 7 Unfortunately, only 22 817 kidney

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Dual and Pediatric En-Bloc Compared to Living Donor Kidney Transplant: A Single Center Retrospective Review

Robinson,

Schöb,

Vargas

et al. 2024

Transplantology

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Safely expanding the use of extended-criteria organ donors is critical to increase access to kidney transplantation and reduce wait list mortality. We performed a retrospective analysis of 24 pediatric en-bloc (PEB) compared to 13 dual-kidney transplantations (DKT) and 39 living donor kidney transplants (LDKT) at the University of Virginia hospital, performed between 2011 and 2019. All living donor kidney transplants were performed in 2017. This year was chosen so that 5-year outcomes data would be available. Primary outcomes were glomerular filtration rate and serum creatinine at 12 and 24 months postoperatively. Secondary outcomes were patient and graft survival. The 1-year creatinine levels (mL/min/1.73 m2) were lower in the PEB group (median 0.9, IQR 0.8–1.4) when compared to the DKT (median 1.4, IQR 1.2–1.5) and LDKT (median 1.3, IQR 1.1–1.5) groups (p < 0.001). The 2-year creatinine levels (mL/min/1.73 m2) were also lower in the PEB group (median 0.8, IQR 0.7–1.08) compared to the DKT (median 1.3, IQR 1.1–1.5) and LDKT (median 1.3, IQR 1.0–1.5) groups (p < 0.001). The glomerular filtration rates demonstrated similar results. Graft survival at 1, 3, and 5 years was 100/100/90, 100/92/69, and 96/96/91 for LDKT, DKT, and PEB, respectively (p = 0.27). Patient survival at 1, 3, and 5 years was 100/100/90, 100/100/88 and 100/100/95 for LDKT, DKT, and PEB, respectively (p = 0.78). Dual KT and PEB transplantation are two alternative techniques to safely expand the donor pool. PEB kidney transplantation, though technically more demanding, provides the best long-term graft function.

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Dual Kidney Transplantation: A Single-Center Experience in Thailand

Cited by 4 publications

References 8 publications

The use of marginal kidneys in dual kidney transplantation to expand kidney graft utilization

The use of marginal kidneys in dual kidney transplantation to expand kidney graft utilization

Dual kidney transplants from adult marginal donors: Review and perspective

Dual and Pediatric En-Bloc Compared to Living Donor Kidney Transplant: A Single Center Retrospective Review

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