Double kidney transplantation in a single-center.

Description

Background: Use of organs from marginal donors is a current strategy to expand the donor pool. Its efficacy is universally accepted among data from multicenter studies. The aim of this study was to evaluate possible significant differences between a monocenter versus multicenter studies. Patients and Methods: Between 1999 and 2008, we performed 59 double kidney transplantation (DKT). Recipient mean age was 63±5 years. Mean HLA-A, -B, and -DR mismatches were 3.69±0.922. Donor mean age was 69±7 years and mean creatinine clearance was 69.8±30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130±216 and 48±11 respectively. The right and left kidney scores were 4.18±2 and 4.21±2, respectively. Results: Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). Three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), while a cyclosporinerelated toxicity occurred in 7 recipients (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. We applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. Conclusions: In our experience the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation.

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