Dual Kidney Transplant: Clinical Experience and Overview of Surgical Techniques

Abstract

Background: Dual Kidney Transplant (DKT) of marginal kidneys has expanded utilizing the extended criteria donor (ECD) organs. The aim of this study is to report the outcomes of dual kidney transplant in our institute and review the surgical techniques of DKT in the Literature. Materials and Methods:Between Jan 1999 and April 2014, 10 cases (8 male and 2 female; mean age 50 years) of DKT were performed in our institute. The surgical techniques include unilateral incision for 9 patients, a midline incision for 1 patient. The literature was reviewed for surgical techniques of DKT.Results: Two recipients had DKT as an En bloc from pediatric donors, whereas others had DKT from elderly donors. The mean surgical time was 5 hours 4 min (Range: 3 hours 40 min to 6 hours 24 min). Two patients had a complication of lymphocele and subsequent development of ureteric stricture. There was no vessel thrombosis and no urine leakage in this cohort. The creatinine level was 137 (± 37.4) µmol/L at 12 months follow-up. The various techniques were described in the literature. Conclusion:DKT is an established technique for expanding use of extended criteria of kidney donors. The clinical outcome is satisfactory and surgical complications can be minimized. Based on our experience in a small series, vascular complication can be prevented with caution during vessel anastomosis and position of the kidney grafts. The single site placement of DKT is preferred from the literature review.