Abstract
Kidney transplantation (KT) is one of the treatment options for patients with chronic kidney disease. The number of patients waiting for kidney transplantation is growing day by day. Various strategies have been put in place to expand the donor pool. Extended criteria donors are now accepted more frequently. Increasing number of elderly donors with age > 60 years, history of diabetes or hypertension, and clinical proteinuria are accepted as donor. Dual kidney transplantation (DKT) is also more frequently done and experience with this technique is slowly building up. DKT not only helps to reduce the number of patients on waiting list but also limits unnecessary discard of viable organs. Surgical complications of DKT are comparable to single kidney transplantation (SKT). Patient and graft survivals are also promising. This review article provides a summary of evidence available in the literature.
Highlights
Kidney transplantation (KT) when compared with dialysis offers improved survival, better quality of life, better social rehabilitation, and less economic cost
Cyclosporine or tacrolimus, prednisolone and MMF were used after induction/selection criteria: expanded criteria donors (ECD) donors aged > 65 years and estimated glomerular filtration rate was between 30 and 60 mL/min 100/Unilateral extraperitoneal placement via Gibson incision/Induction therapy consisted of antithymocyte globulin (ATG) or Basiliximab
Bearing this evidence in mind, Dual kidney transplantation (DKT) should be offered to elderly patients with lower immunological risk and a normal body mass index
Summary
KT when compared with dialysis offers improved survival, better quality of life, better social rehabilitation, and less economic cost. The number of patients waiting to get a kidney has increased tremendously. The number of patients on waiting list for kidney in July 2016 was 99,413 in USA as per data of Organ Procurement and Transplantation Network (OPTN). Around 20 to 40% of ECD and dual kidneys recovered were discarded in US [2]. The discard rate is 8% in Europe which is comparatively lower than the United States of America [3,4,5]. Increased nephron mass supply by simultaneously transplanting two suboptimal kidneys to the same recipient may work better than a single kidney. This will both reduce the number of the patients on waiting lists and discard rates. This review does not include pediatric dual kidney donation or implantation
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