Dual-Kidney Transplants as an Alternative for Very Marginal Donors: Long-Term Follow-Up in 63 Patients

Serres, Sacha A. De; Caumartin, Yves; Noël, Raphaële; Lachance, Jean-Guy; Côté, Isabelle; Naud, Alain; Fradet, Yves; Mfarrej, Bechara; Agharazii, Mohsen; Houde, Isabelle

doi:10.1097/tp.0b013e3181f8f2b8

Cited by 34 publications

(40 citation statements)

References 32 publications

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“…Despite the number of DKT selection parameters (see review part of this paper), there is no uniformity among transplant centers. 6 To date, there is only 1 prospective controlled study that evaluated allocation algorithm. In this study, Snanoudj and associates 10 used allocation criteria proposed by Remuzzi and associates.…”

Section: Discussionmentioning

confidence: 99%

“…Another paper compared calcineurin-inhibitor-free with cyclosporine-based immunosuppression protocols and reported significantly lower rates of delayed graft function (DGF) and a lower rate of cytomegalovirus infection in the sirolimus group with no difference in creatinine at 1 year. 26 The incidence of acute rejection in DKT recipients was shown to be lower than it was in SKTs, 6,12,14 which suggests the possibility that increasing the antigenic load does not enhance immune response. 13 …”

Section: Immunosuppression Protocolmentioning

confidence: 99%

“…6,17 Cruzado and associates 25 analyzed 2 groups of patients who received either cyclosporinebased immunosuppression (cyclosporine, mycophenolate mofetil, and prednisolone) or calcineurin-inhibitor-free protocol (thymoglobulin induction, sirolimus, mycophenolate mofetil, and prednisolone), and did not find differences in graft function or survival using calcineurin-inhibitor-free immunosuppression. Another paper compared calcineurin-inhibitor-free with cyclosporine-based immunosuppression protocols and reported significantly lower rates of delayed graft function (DGF) and a lower rate of cytomegalovirus infection in the sirolimus group with no difference in creatinine at 1 year.…”

Section: Immunosuppression Protocolmentioning

confidence: 99%

“…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.…”

Section: Surgical Technique Of Dual Kidney Transplantmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Immunosuppression Protocolmentioning

confidence: 99%

Section: Immunosuppression Protocolmentioning

confidence: 99%

Section: Surgical Technique Of Dual Kidney Transplantmentioning

confidence: 99%

See 2 more Smart Citations

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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show abstract

“…However, because of increasing numbers of extended criteria donations 14 and improved techniques of organ procurement and transplant, there is an increased trend of transplanting en bloc kidneys from a pediatric donor 15,16 or dual transplant from elderly donors 17,18 to compensate for low nephron mass. With respect to ureteroneocystostomy, these kidneys are associated with the same challenges as with double-ureter kidney transplant.…”

Section: Abbas Ghazanfar Et Al/experimental and Clinical Transplantatmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Renal transplant with double ureters is uncommon. However, with increasing numbers of en bloc and dual transplants from marginal donors, we frequently observe 2 ureters for implant. The current study reviewed our experience with 76 double-ureter renal transplants. Materials and Methods:We performed a retrospective analysis of renal transplant performed in 2 institutes from 1996 to 2011. We recorded the outcomes of renal transplants with double ureters including complications. We compared outcomes with renal transplants with single ureters. Results: Irrespective of the technique used for implant, we recorded no significant risk of complications of double-compared with singleureter renal transplants. There were no significant differences in patient and graft survival. Conclusions: We believe that double-ureter transplant does not require additional risk discussion with the recipient because it is safe. However, when ureteral stents are used, we should ensure that a mechanism is in place for both stents to be removed postoperatively.

Dual-Kidney Transplants as an Alternative for Very Marginal Donors: Long-Term Follow-Up in 63 Patients

Abstract: DKT patients can expect long-term results comparable with single kidney ECD. The implementation of a DKT program in our unit safely increased the pool of organs from marginal donors.

Cited by 34 publications

References 32 publications

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

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

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