Dual Kidney Transplants as Policy to Optimize the Allocation of Marginal Donor Kidneys: Analysis of the French Cohort Since 2002.
1Agence de la Biomédecine, Saint Denis, France
2Necker hospital, Paris, France
3Foch hospital, Suresnes, France
4Saint Louis Hospital, Paris, France
5Bicêtre Hospital, Kremlin Bicetre, France
6Tenon hospital, Paris, France
7Pasteur hospital Nice, Nice, France
8Department of Chirurgie de la Transplantation Pav V and Department of Immunologie Clinique Transplantation Pav P, Edouard Herriot Hospital Group, Lyon, France.
Meeting: 2016 American Transplant Congress
Abstract number: B206
Keywords: Donors, Graft survival, Kidney transplantation, marginal, Renal function
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: Kidney Transplantation: KDPI, HCV/Matching, Donor Age
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
The aim of this national multicentre cohort study was to assess the safety of dual kidney transplantation (DKT) in terms of patient and graft survival and renal function, and to compare these results with those obtained from single kidney transplantation (SKT). Our analysis was restricted to first transplants realized between May 2002 and December 2014, with marginal donor, defined as brain death donor older than 65y and with an estimated glomerular filtration rate (eGFR) lower than 90 ml/min . Recipients being aged less than 65 or with a PRA over 25% were excluded.
Survival rates were estimated using the Kaplan-Meier method. Cox and logistic models were used in multivariate analysis.
461 DKT and 1131 SKT were included. DKT recipients had lower BMI, shorter waiting time and dialysis duration. DKT donors were older, had higher BMI, more frequently a history of hypertension and lower eGFR. Mean cold ischemia time (21h) was 3h longer for DKT.
While primary non function (PNF) (6%) and delayed graft function (DGF) (30%) did not differ between SKT and DKT, 1 year eGFR was lower in SKT recipients (39.5 vs. 49.3 ml/min, p<0.001). Graft survival and death-censored graft survival were significantly better in DKT even after adjustment for recipient and donor risk factors. Nevertheless no difference was retrieved concerning patient survival. Three-years graft and patient survival rates for DKT vs. SKT were respectively as follows: 79% vs. 73% (p=0.003) and 86% versus 85% (p=0.55).
Good results obtained by DKT are an invitation for some teams to develop DKT. In a context of organ shortage, DKT appears to be a good option to optimize the use of kidneys from marginal donor otherwise discarded. When a kidney from a marginal donor is proposed, national regulation and transplant teams should decide between SKT or DKT by taking into account two main objectives: maximizing the use of grafts and reducing cold ischemic time duration.
CITATION INFORMATION: Savoye E, Snanoudj R, Hiesse C, Peraldi M.-N, Durrbach A, Ouali N, Durand M, Badet L, Macher M.-A. Dual Kidney Transplants as Policy to Optimize the Allocation of Marginal Donor Kidneys: Analysis of the French Cohort Since 2002. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Savoye E, Snanoudj R, Hiesse C, Peraldi M-N, Durrbach A, Ouali N, Durand M, Badet L, Macher M-A. Dual Kidney Transplants as Policy to Optimize the Allocation of Marginal Donor Kidneys: Analysis of the French Cohort Since 2002. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/dual-kidney-transplants-as-policy-to-optimize-the-allocation-of-marginal-donor-kidneys-analysis-of-the-french-cohort-since-2002/. Accessed August 20, 2018.« Back to 2016 American Transplant Congress