Dual Kidney Transplantation Involving Organs From Expanded Criteria Donors: A Review of Our Series and an Update on Current Indications

Polo, J. Medina; Pamplona-Casamayor, M.; Miranda-Utrera, N.; González-Monte, Esther; Passas-Martínez, J.B.; Belmonte, Amado Andrés

doi:10.1016/j.transproceed.2014.10.025

Cited by 13 publications

(17 citation statements)

References 16 publications

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“…39,41,42,53,54,[58][59][60][61][62][63][64]74,75) are comparable to ours (respectively 100% and 87.6%), as well as the recipient survival rates at 1 (89.7-100%, Ref. 38,39,41,42,44,52,[54][55][56]59,[61][62][63]75,77,78) and 3 years (80-97.5%, Ref. 39,41,42,54,[58][59][60][61][62][63]75), both at 97.4% in our series.…”

Section: Discussionsupporting

confidence: 85%

“…Other DKT series reported graft survival rates at 1 (82-100% Ref. 37,39,41,42,45,[52][53][54][55][56]59,[61][62][63]74,75,77,78) and 3 years (76-95%, Ref. 39,41,42,53,54,[58][59][60][61][62][63][64]74,75) are comparable to ours (respectively 100% and 87.6%), as well as the recipient survival rates at 1 (89.7-100%, Ref.…”

Section: Discussionsupporting

confidence: 82%

“…38,39,(39)(40)(41)(42)(43)(44)52,54,56,57,(60)(61)(62)64,65,74,75,78), these results being probably related to the use of anti-thymocyte globulin for immunosuppressive therapy induction in most of DKT (71.8%) in our centre. However, mean values of serum creatinine and GFR seem to be similar at 12 months (respectively 148.9 vs 119-159 lmol/l [38,41,43,44,52,54,[56][57][58]61,62,74,75,77,78] and 46.7 vs 42-55 ml/min, Ref. 38,40,41,43,52,53,55,57,62,64).…”

Section: Discussionmentioning

confidence: 92%

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Safety of dual kidney transplantation compared to single kidney transplantation from expanded criteria donors: a single center cohort study of 39 recipients

Mendel¹,

Albano²,

Bentellis³

et al. 2018

Transpl Int

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Our objective was to compare the outcomes of dual kidney transplanataion (DKT) to single kidney transplantation (SKT) performed with grafts from expanded criteria donors (ECD) in recipients ≥65 years, focusing on surgical complications. All kidney transplantations (KT) performed between 2006 and 2014 in our institution were analysed. DKT was indicated according to the criteria of the French national Agence de la Biomedecine. Thirty-nine DKT and 155 SKT were included, with a median follow-up of 36 and 26.5 months, respectively. The rate of early surgical revisions was not significantly higher after DKT (23.1% vs 15.5% (P = 0.2593)) but more venous graft thromboses (12.8% vs 3.2% (P = 0.02)) were reported. The glomerular filtration rate (GFR) 24 months after KT was significantly higher after DKT (45.0 ± 16.3 vs 39.8 ± 13.8 ml/min/1.73m ; P = 0.04) and allowed shorter waiting time without a significant increased risk of surgical revision, excepted for venous graft thrombosis, more frequent after DKT. Graft survivals were not significantly different and GFR was higher after DKT. DKT seems to remain an appropriate strategy to address the growing graft shortage in elderly patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Safety of dual kidney transplantation compared to single kidney transplantation from expanded criteria donors: a single center cohort study of 39 recipients

Mendel¹,

Albano²,

Bentellis³

et al. 2018

Transpl Int

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“…On the other hand, if the patient has a narrow pelvis, bilateral placement may appear advantageous because it is easier to fit both kidneys in the space available. At the University Hospital in Madrid, unit practice is to place the grafts bilaterally so that it is easy to access the vessels; there is enough space; and if a surgical complication does occur, it does not impact on the other graft . (Medina‐Polo [josemedinapolo@movistar.es], email, July 26, 2016).…”

Section: Discussionmentioning

confidence: 99%

Dual kidney transplant techniques: A systematic review

Cocco

Shahrestani

Cocco

et al. 2017

Clinical Transplantation

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“…Concerns were raised regarding inadequate nephron mass and expected life span of the ECD kidneys. However, literature review reveals satisfactory outcome of DKT in terms of graft function [8].…”

Section: Discussionmentioning

confidence: 97%

Dual Kidney Transplant: Clinical Experience and Overview of Surgical Techniques

He¹

2015

J Surg Surgical Res

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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.

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Dual Kidney Transplantation Involving Organs From Expanded Criteria Donors: A Review of Our Series and an Update on Current Indications

Cited by 13 publications

References 16 publications

Safety of dual kidney transplantation compared to single kidney transplantation from expanded criteria donors: a single center cohort study of 39 recipients

Safety of dual kidney transplantation compared to single kidney transplantation from expanded criteria donors: a single center cohort study of 39 recipients

Dual kidney transplant techniques: A systematic review

Dual Kidney Transplant: Clinical Experience and Overview of Surgical Techniques

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