Two-as-one monolateral dual kidney transplantation

Area of Science:

• Nephrology
• Transplant Surgery
• Urology

Background:

• Dual kidney transplantation (DKT) utilizes marginal kidneys to improve renal function in transplant candidates.
• DKT can be a major surgery, posing higher risks in older recipients compared to single kidney transplantation.
• Some centers now use monolateral placement for both kidneys instead of bilateral placement.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel monolateral placement technique for dual kidney transplantation.
• To assess surgical complications, graft function, and patient survival rates associated with this DKT method.

Main Methods:

• A cohort of 35 DKTs was reviewed over 5 years.
• A new technique involving monolateral placement of DKT was applied to 10 recipients.
• The arteries and veins of the two kidneys were joined, and the pair was anastomosed to the recipient's external iliac vessels.

Main Results:

• The rate of delayed graft function was 20%.
• No surgical complications were observed in the entire DKT series.
• Graft and patient survival rates reached 90% at a median follow-up of 30 months, with one case of late rejection and ureteral stricture.

Conclusions:

• Monolateral placement of dual kidneys appears to be the safest method for DKT, reducing surgical risk and morbidity.
• This joined monolateral DKT technique may improve patient outcomes by decreasing cold ischemia time and surgical trauma.