232.6: Outcomes of dual kidney transplantation: Comparison to single kidney transplantation from standard and expanded criteria donors.

Abstract

Background: Nowadays, kidney transplantation (KT) is accepted as the treatment of choice for patients with end-stage renal disease (ESRD). However, due to a severe donor shortage, many ESRD patients are still on the waiting list and are suffering from the disease, even though use of kidney from expanded criteria donor (ECD) is increasing. Dual kidney transplantation (DKT) can be the way to use more kidneys from ECDs. We are trying to compare the outcomes of Dual kidney transplantation with those of single kidney transplantation from standard criteria donors (SCDs) and ECDs. Methods: In 2014, we started dual kidney transplantation using kidneys from donors of over 70 years with one of the risk factor including serum creatinine (sCr) level is over 3.0 mg/dl, or estimated glomerulus filtration rate (eGFR) is under 30 ml/min. By 2017, we performed 15 cases of DKT. We compared the outcomes of these 15 recipients with 124 patients who got kidney transplant from SCDs and 80 patients who got kidney transplant from ECDs. Results: Donors of DKT were older, more diabetic, and had higher sCr levels than ECDs and SCDs. Recipients of DKT was also older and diabetic than recipients of ECD and SCDs. Recipients of DKT showed less slow graft function(SGF) and lower nadir sCr than recipients of ECDs. Time to nadir sCr was shorter in DKT than in ECD KT. Graft survival rates and patient survival rates were not significantly different among three groups. Risk factor analysis for graft failure revealed that donor group was not the risk but recipient age and nadir sCr. Conclusions: The graft survival rates of DKT were compatible with those of ECD KT and SCD KT. Some outcomes such as the incidence of SGF, nadir sCr level, and time to nadir sCr were even more favorable in DKT than in ECD KT. Therefore, DKT should be considered as an option to expand donor pool.