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Dual kidney transplantation (DKT) offers improved graft function compared to single kidney transplantation (SKT) using marginal donors. However, DKT is associated with more complications and longer hospital stays.

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Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Organ Donation

Background:

  • Declining kidney donor pool due to advanced age, hypertension, kidney dysfunction, and diabetes.
  • Dual kidney transplantation (DKT) as a strategy to utilize kidneys from marginal donors.
  • Potential for improved outcomes by implanting two kidneys from a single donor into one recipient.

Purpose of the Study:

  • To compare the outcomes of dual kidney transplantation (DKT) with single kidney transplantation (SKT) using matched marginal donor criteria.
  • To evaluate graft function, survival rates, and complication profiles of DKT versus SKT.

Main Methods:

  • Retrospective analysis of patients undergoing DKT and SKT between June 2010 and May 2014.
  • Inclusion criteria for DKT donors: DBDs >70 years (with or without diabetes/hypertension), DCDs >65 years (with diabetes/hypertension), and DCDs >70 years.
  • Comparison with SKT recipients using similarly matched donor criteria.

Main Results:

  • DKT recipients showed significantly better median estimated glomerular filtration rate (eGFR) at 12 and 36 months compared to SKT recipients.
  • One-year graft survival (88% vs. 96%) and patient survival (94% vs. 98%) were similar between DKT and SKT groups.
  • DKT group experienced longer median hospital stay, higher intensive care unit admission rates, and more wound complications.

Conclusions:

  • Dual kidney transplantation demonstrates superior graft function compared to single kidney transplantation with matched marginal donors.
  • Graft and patient survival rates are comparable between DKT and SKT.
  • Increased complication rates, including longer hospital stays and ICU admissions, are associated with DKT.