Dual kidney transplantation: a single-center experience

Dual kidney transplantation (DKT) is an alternate approach to use marginal kidneys not suitable to be allocated for single kidney transplant. This retrospective study reviewed the short- and long-term outcomes regarding graft and patient survivals over a 9-year period at a single center.

From 2005 to 2013, 33 DKTs were performed in our unit, where allocation was guided by clinical parameters mainly. The mean ages for recipients and donors were 58.6 ± 12.5 and 54.8 ± 13.6 years, respectively. Cold ischemia time was 21.4 ± 4 hours, and mean HLA mismatch for HLA-A, HLA-B, and HLA-DR was 3.06 ± 1.07. Immunosuppression regime was tacrolimus based.

Median follow-up time of 56 months showed patient and death-censored graft survivals at 1, 3, and 5 years to be 90% and 84%, 90% and 81%, and 84% and 81%, respectively. The rate of delayed graft function was 46.9% (n = 15), the rate of primary graft function was 46.9% (n = 15), the rate of and primary graft nonfunction was 6.2% (n = 2). Nineteen patients (59.4%) required biopsy: 12 of them showed acute tubular necrosis and 7 had rejection (1 needed graft removal, 4 were treated successfully with steroid and/or antithymocyte globulin, and 2 did not require treatment).

Outcomes of DKT in our center were satisfactory and similar to those of other transplant centers regarding patient and graft survivals.