Short-term outcome of dual kidney transplantation at a single center

Rigotti, Paolo; Cadrobbi, R.; Furian, Lucrezia; Baldan, N; Sarzo, Giacomo; Liberati, Laura; Valente, Marialuisa; Ancona, Ermanno

doi:10.1016/s0041-1345(01)02595-7

Cited by 12 publications

(18 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More than a decade after the first report of DKT from an adult deceased donor (7), many centers now perform DKT using various organ selection criteria and surgical techniques (8)(9)(10)(11), including the extra-or intraperitoneal bilateral placement of the two kidneys (9)(10)(11) through two separate Gibson incisions or one midline incision (10)(11)(12).…”

Section: As a Results Of (I) The Shortage Of Kidneys For Transplantatimentioning

confidence: 99%

Technical Aspects of Unilateral Dual Kidney Transplantation from Expanded Criteria Donors: Experience of 100 Patients

Ekser

Furian

Broggiato

et al. 2010

American Journal of Transplantation

View full text Add to dashboard Cite

One option for using organs from donors with a suboptimal nephron mass, e.g. expanded criteria donors (ECD) kidneys, is dual kidney transplantation (DKT). In adult recipients, DKT can be carried out by several techniques, but the unilateral placement of both kidneys (UDKT) offers the advantages of single surgical access and shorter operating time. One hundred UDKT were performed using kidneys from ECD donors with a mean age of 72 years (Group 1). The technique consists of transplanting both kidneys extraperitoneally in the same iliac fossa. The results were compared with a cohort of single kidney transplants (SKT) performed with the same selection criteria in the same study period (Group 2, n = 73). Ninety-five percent of UDKTs were positioned in the right iliac fossa, lengthening the right renal vein with an inferior vena cava patch. In 69% of cases, all anastomoses were to the external iliac vessels end-to-side. Surgical complications were comparable in both groups. At 3-year follow-up, patient and graft survival rates were 95.6 and 90.9% in Group 1, respectively. UDKT can be carried out with comparable surgical complication rates as SKT, leaving the contralateral iliac fossa untouched and giving elderly recipients a better chance of receiving a transplant, with optimal results up to 3-years follow-up.

show abstract

Section: As a Results Of (I) The Shortage Of Kidneys For Transplantatimentioning

confidence: 99%

Technical Aspects of Unilateral Dual Kidney Transplantation from Expanded Criteria Donors: Experience of 100 Patients

Ekser

Furian

Broggiato

et al. 2010

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Fewer rejections, similar 3 month and 1-year serum creatinine levels were found in recipients of dual transplants versus recipients of single ideal kidney grafts. Reports of successful dual renal transplants from elderly kidney donors [95, 96, 97]or non-heart-beating donors [98]are also available in Europe. All these findings are corroborated by a recent prospective, case-control study involving transplantation centers in Europe, Canada and United States, aimed to compare the outcome of transplantation of two marginal versus single ideal kidneys [99].…”

Section: From Single To Dual Marginal Kidney Transplantationmentioning

confidence: 99%

Tackling the Shortage of Donor Kidneys: How to Use the Best that We Have

et al. 2003

View full text Add to dashboard Cite

Shortage of kidney donor is still a major limitation for renal transplantation programs. This review focuses on the emerging practices, adopted to increase transplant activities, of expanding the criteria for donor and recipient selection without exposing the recipient to the drawbacks of a graft with inadequate nephron mass. Expanding the donor pool inevitably led to consideration for kidney transplantation of organs from older donors or from donors with hypertension, diabetes or other renal diseases. To fit the reduced performance of these suboptimal organs with the renal requirement of the recipient, selection of recipients with reduced metabolic requirements or increase of nephron mass by simultaneous transplantation of two suboptimal kidneys in the same recipient have been pursued. However, a critical aspect of both approaches is to quantify functioning nephron mass provided to the recipient by pre-transplant kidney biopsies. Morphological parameters assessed on kidney biopsies at the time of donor evaluation may serve to quantify the preserved tissue and to discriminate chronic irreversible lesions from acute changes that may account for a transiently impaired renal function in the donor, but that may recover after transplant.

show abstract

“…Es así que, algunos centros de trasplante evalúan la utilización de injertos renales de donantes marginales ( 7,8 ). En concordancia con otros países, la edad promedio de los donantes cadavéricos va en ascenso ( 1,[9][10][11] ). Este cambio en el perfil del donante revela características peculiares del injerto renal y de su evolución en el postrasplante ( 1,9,12 ).…”

Section: Introductionunclassified

“…Este cambio en el perfil del donante revela características peculiares del injerto renal y de su evolución en el postrasplante ( 1,9,12 ). Los donantes añosos (mayores de 55 años de edad) con frecuencia cursan con hipertensión arterial y/o diabetes mellitus, lo que conlleva que la masa nefronal sea subóptima y su reserva funcional disminuida ( 2,10,13 ). Los injertos renales procedentes de donantes añosos además son muy sensibles a cualquier noxa (isquemia, rechazo, fármacos nefrotóxicos) y poseen una capacidad de recuperación marcadamente inferior comparados con los injertos procedentes de donantes jóvenes ( 2,8,9,14 ).…”

Section: Introductionunclassified

“…Nuestra organización trasplantadora implementa un protocolo en el que se utiliza ambos riñones del donante añoso en un mismo receptor (trasplante renal doble -TRD), con el fin de garantizar mayor masa nefronal, previniendo así el deterioro progresivo de la función del injerto ( 7,8,10 ). Resaltamos la importancia de la histología renal en la selección de estos donantes ( 2, [14][15][16][17] ) y se analiza la función del injerto y su sobrevida en los once primeros pacientes sometidos a TRD.…”

Section: Introductionunclassified

See 1 more Smart Citation