Dual renal grafts: expansion of the donor pool from an overlooked source

Dafoe, Donald C.; Alfrey, Edward J.

doi:10.1007/s001470050123

Cited by 13 publications

(7 citation statements)

References 20 publications

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“…Nephrotoxicity of calcineurin inhibitors can further compromise nephron mass and long‐term function. Doubling the nephron mass by transplanting the kidneys en bloc might overcome these problems (17–21). The ESP allocation scheme therefore included the option of transplanting both kidneys to a single recipient in cases in which the donor creatinine clearance was below 70 mL/min.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Eurotransplant Senior Program. The Results of the First Year

Smits

Persijn

Houwelingen

et al. 2002

American Journal of Transplantation

166

104

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On 4 January 1999, the Eurotransplant Senior Program (ESP) was implemented within the Eurotransplant kidney allocation scheme. Patients and Methods: Kidneys obtained from donors aged over 65 years of age (65 π) were allocated to a selected group of nonimmunized 65 π patients undergoing their first transplant. All transplants were performed locally to minimize cold-ischemic time. All transplants performed with kidneys from elderly donors that were allocated via ESP (ESP group) were compared to transplants performed with similar kidneys allocated via the standard renal allocation system (control group). Initial kidney function and 1-year graft outcome were assessed. Results: In 1999, 227 ESP and 102 control transplants were performed. The duration of cold-ischemic time was 12 and 19 h for the ESP and control groups, respectively. No rejection episodes occurred in 60% and 67% of the ESP patients and controls, respectively, while a direct kidney function was observed in 59% of ESP and 49% of control patients. The 1-year graft survival rates, censoring for graft losses due to deaths in patients with functioning grafts, were 86% and 79%, respectively. Conclusion: An old-for-old renal allocation algorithm can be successful provided that risk factors, such as cold-ischemic time, are reduced.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Eurotransplant Senior Program. The Results of the First Year

Smits

Persijn

Houwelingen

et al. 2002

American Journal of Transplantation

166

104

View full text Add to dashboard Cite

show abstract

“…It is possible that there may be reluctance on the part of transplant centers due to concerns about the increased risk of surgical complications, the prolonged warm and cold ischemic time and associated risk of DGF, and the uncertainty in determining which organs are suitable for single versus dual use. Longer time under anesthesia, and twice the number of dissections and vascular anastomoses, may contribute to a higher surgical risk with DKT (18). It is important to note, however, that since the first reported DKT in 1996 (19), there have been various surgical techniques, including unilateral placement of both kidneys (20), which successfully minimize the length of surgery and may ameliorate some of these concerns.…”

Section: Which Kidneys Should Be Used For Dkt?mentioning

confidence: 99%

Outcomes of Dual Adult Kidney Transplants in the United States: An Analysis of the OPTN/UNOS Database

Gill

Cho²,

Danovitch³

et al. 2008

Transplantation

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“…7 However, subsequent analyses of these patients reveals that the recipients of DKTs from donors 54 to 60 years old had low serum creatinine levels up to 2 years after transplant and that may mean that these kidneys could have been used for an SKT. 8 Singh and associates 9 found that donors with an eGFR of 1.2 mL/s for a DKT was a better discriminator kidney transplant function than was an eGFR of 1.5 mL/s. In a recent prospective study, Snanoudj and associates 10 found that a donor eGFR between 0.5 and 1.0 mL/s was easily applicable to allocate ECD kidneys from donors over 65 years of age for a DKT.…”

Section: Introductionmentioning

confidence: 99%

Dual Kidney Transplant: A Single-Center Experience and Review of the Literature

Balaz

Rokošný²,

Wohlfahrt³

et al. 2013

Exp Clin Transplant

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Objectives: Adult dual kidney transplant is a strategy to overcome the imbalance between limited nephron mass supplied from an older donor and a recipient with a metabolic request. Materials and Methods: In our report, we review the literature and present our single-center experience. From June 2007 until July 2012, nine hundred twenty-eight single and seventeen dual kidney transplants from deceased donors were performed. Results: The average donor was 71.5 ± 3.6 years of age with an average serum creatinine, creatinine clearance, and an average number of sclerotic glomeruli, 106.1 ± 44.2 µmol/L, 0.97 ± 0.37 mL/s, and 22.4 ± 14.2. Immediate graft function and acute rejection episodes were observed in 75% and 6% of patients. The overall patient survival rates at 1 and 2 years after transplant were 93%. The overall graft survival rates at 1 and 2 years were 88%. Conclusions: Previous studies and our single-center experience suggest that the dual transplant procedure may help improve results of kidney transplants from expanded criteria donors and extend the donor pool by using kidneys that would be discarded otherwise.

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Dual renal grafts: expansion of the donor pool from an overlooked source

Cited by 13 publications

References 20 publications

Evaluation of the Eurotransplant Senior Program. The Results of the First Year

Evaluation of the Eurotransplant Senior Program. The Results of the First Year

Outcomes of Dual Adult Kidney Transplants in the United States: An Analysis of the OPTN/UNOS Database

Dual Kidney Transplant: A Single-Center Experience and Review of the Literature

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