Abstract
PurposeDual kidney transplantation (DKT) offers a way to extend the use of kidneys from expanded criteria donors (ECDs). Here, we compared the outcomes of DKT with those of single kidney transplantation from standard criteria donors (SCDs) and ECDs.MethodsIn 2014, we began performing DKT using both kidneys from deceased donors greater than 70 years of age with one of two risk factors: serum creatinine (sCr) level over 3.0 mg/dl or eGFR under 30 ml/min. By 2017, we had performed 15 DKTs. We compared the outcomes of the 15 DKT recipients with those of 124 patients who received a kidney from an SCD and 80 patients who received a kidney from an ECD.ResultsCompared with ECDs and SCDs, DKT donors were older, had a higher diabetes burden, and a higher sCr level (p < 0.01, < 0.01, and 0.03, respectively). DKT recipients were also older and had a higher diabetes burden than recipients of kidneys from ECDs and SCDs (p < 0.01, both). DKT recipients had a lower nadir sCr and shorter duration to nadir sCr than single ECD KT recipients (p < 0.01and 0.04, respectively).ConclusionsThe survival rates of DKT grafts were compatible with those of single KT grafts. Therefore, DKT may be considered a suitable an option to expand the donor pool.
Highlights
The rapidly growing incidence of chronic kidney disease and limited supply of donor organs has led to an increase in the number of patients awaiting kidney transplantation (KT)
To overcome this organ shortage, kidneys from expanded criteria donors (ECD) or suboptimal donors are widely used for transplantation
We screened the records of 242 recipients who underwent deceased donor kidney transplantation (DDKT) between January 2014 and November 2017 in Samsung Medical Center
Summary
Study design This study was a retrospective single center historical cohort study and analyzed Samsung Medical Center electronic medical record and kidney transplantation database. We screened the records of 242 recipients who underwent deceased donor kidney transplantation (DDKT) between January 2014 and November 2017 in Samsung Medical Center. DKTs were attempted when the donor was older than 70 and met at least one of the following criteria: (1) an eGFR calculated by MDRD equation < 30 mL/min without improvement or (2) an sCr level > 3.0 mg/dL without improvement or, regardless of donor age, when the single kidney was refused by all other centers. Postoperative management We used rabbit anti-thymocyte globulin (rATG, 1.5 mg/ kg, three doses on days 0, 1, 2) as an induction immunosuppressive agent for recipients with donor-specific antiHLA antibodies (DSAs) or history of KT, as well as in single ECD KT and DKT cases.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
