Cadaveric "two-in-one" kidney transplantation from marginal donors: Experience of 26 cases after 3 years

Citation
Kh. Dietl et al., Cadaveric "two-in-one" kidney transplantation from marginal donors: Experience of 26 cases after 3 years, TRANSPLANT, 70(5), 2000, pp. 790-794
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
TRANSPLANTATION
ISSN journal
0041-1337 → ACNP
Volume
70
Issue
5
Year of publication
2000
Pages
790 - 794
Database
ISI
SICI code
0041-1337(20000915)70:5<790:C"KTFM>2.0.ZU;2-R
Abstract
Background. Because of the problem of organ shortage, the use of renal tran splants from marginal donors has been tested by different procedures. Methods. In our center 26 recipients (59+/-7 years) underwent double renal transplantation from July 1996 to August 1999 using marginal donors (71+/-6 years). A special scoring was applied that included donor age, serum creat inine, the grade of glomerulosclerosis, and kidney weights leading to the d ecision whether single or dual or no kidney transplantation was performed. Results. After an average follow-up of 18+/-10 months 22 of 26 (85%) double kidney transplant recipients are alive and have functioning grafts. Three patients died with well-functioning grafts. The actuarial 1-year patient an d graft survival rate was 94% (n=18), the 8-year rate 92% (n=12). Two patie nts lost one graft each without becoming dialysis dependent. The average se rum creatinine was 1.6+/-0.5 mg/dl after 12 months (n=17) and 1.9+/-0.6 mg/ dl after 24 months (n=11). Primary nonfunction occurred in 31%, acute rejec tion within the first 6 months in 14%. Ten patients who received single old grafts according to our score had similar transplant survival rates but wo rse graft function after 1 year. Conclusions. Transplant function and survival of patients after dual kidney transplantation indicate that this procedure is reasonable to ameliorate t he problem of organ shortage. The most crucial point is to establish a wide ly accepted standardized scoring for the donors leading to single, dual, or refusal of transplantation.