Monolateral Dual Kidney Transplantation From Marginal Donors

Shahrestani

Clinical Transplantation

et al. 2017

Section: Resultsmentioning

confidence: 99%

“…Two of the 10 donors whose kidneys were used in a DKT in Lee's study did not fit an ECD definition . Andres, Remuzzi, Johnson, D'Arcy, Veroux M, Gaber, Moore, and Veroux P all used a biopsy score to determine dual allocation . Ekser used a biopsy score if the patient had elevated creatinine, hypertension, or diabetes as well as being over 60.…”

Section: Resultsmentioning

confidence: 99%

Dual kidney transplant techniques: A systematic review

Shahrestani

Clinical Transplantation

et al. 2017

Transplant International

“…One should temper these results; Veroux et al. [12] do not report a comparison between unilateral and bilateral placements, and therefore cannot conclude about the advantages of this technique. Moreover, patients with severe atherosclerotic aorto‐iliac disease were excluded.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, only two studies have previously reported unilateral placement of allografts in DKT [12,13]; interestingly, the authors report excellent graft survival and advocate this technique as it allows significant reduction in cold ischemia time for the second graft. One should temper these results; Veroux et al.…”

Section: Discussionmentioning

confidence: 99%

Single graft loss in dual renal transplant recipients: impact of graft placement on recipient outcomes

Timsit

Rabant

Snanoudj

et al. 2010

Summary We aimed to assess the impact of graft placement in dual renal transplantation on the risk for single graft loss and to report recipient outcomes. Between 2004 and 2007, 55 dual renal transplants were performed at our institution. Allografts were placed bilaterally (one in each iliac fossa) in 42 patients and unilaterally (both in the same iliac fossa) in 14 patients. Nine recipients (16.4%) underwent explantation of a single graft as a consequence of vascular thrombosis designated as the SINGLE group, whereas 46 had two functional allografts (DUAL group). There was a higher rate of graft loss in case of unilateral placement (n = 5/14) compared with bilateral placement (n = 4/41) (35.7% vs. 9.8%, P = 0.035). One‐year glomerular filtration rate was significantly lower in the SINGLE group (29.4 ml/min/1.73 m2 vs. 49.4 ml/min/1.73 m2 in the DUAL group, P < 0.05). Significantly, none of the nine recipients of the SINGLE group returned to dialysis with a mean follow‐up of 34.1 months. Graft survival at 1 year was 100% and 97.9% in SINGLE and DUAL groups, respectively. Unilateral placement of both allografts is associated with an increased risk of single graft loss and therefore lower renal function at 1 year. However, this strategy is safe in selected indications.

“…6 Both kidneys can be transplanted together in 1 (unilateral) or 2 (bilateral) separate iliac fossae through an extraperitoneal or a transperitoneal approach. 22 Many transplant centers perform DKTs using bilateral technique with 2 separate extraperitoneal incisions. Boggi and associates 23 showed a higher incidence of lymphoceles using unilateral graft placement compared with kidneys transplanted as separate grafts; also these grafts had a higher risk of hemorrhage with bilateral incisions.…”

Section: Surgical Technique Of Dual Kidney Transplantmentioning

confidence: 99%

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

Balaz

Rokošný²,

Wohlfahrt³

et al. 2013

Exp Clin Transplant

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.