*Purpose: Less than perfect kidneys are often difficult to place in the current kidney allocation system. The kidneys have to travel extended distances , increasing cold ischemic time and the risk of discard . The study was performed to evaluate suitability of dual kidney transplantation for kidneys offered late in the match run.

*Methods: We performed a retrospective review of our series of dual kidney transplants (DKT) performed over the last 5 years . The database generated was divided into 2 groups( Group 1≤100, Group 2≥101) based on the sequence number of the recipient on the match run. HTPDKT kidneys were organs in group 2. The groups were then compared for donor and recipient characteristics, transplantation times and recipient outcomes. Statistical significance was evaluated using the paired t- test .

*Results: A total of 34 kidney transplants met study criteria. Group 1(n=12) had a lower rate of delayed graft function(DGF) 50% v/s 63% when compared to group 2(n=22) . 50% of group 1 kidneys were DCD organs while 31% of group 2 kidneys were DCD organs. The mean cold ischemic time in group 1 was 19.5±6.3 hrs, and in group 2 was 27.2±5.86 hrs (p≤0.05). The KDPI scores in the two groups were comparable at a mean of 73% and 81% respectively . The median sequence number at transplantation in group 1 was 11, while that in group 2 was 2101. While all the kidneys in group 1 were locally recovered, 63% of the kidneys in group 2 were imports. The mean recipient serum creatinine in group 1 was 1.57±0.73mg/dl and group 2 1.79±1.20 mg/dl (p=0.50). The Gfr in the two groups was not different either (58±21ml/min v/s51±25 ml/min p=0.39) The median follow up was 562 days in group 1, and 665 days in group 2. Death censored one- year graft survival was 100% in both groups. Our data demonstrates the utility of dual kidneys for transplantation despite prolonged cold ischemic times when the kidneys are offered to recipients lower down in the match run. The risk of delayed graft function is higher due to prolonged cold ischemic time with acceptable graft function and outcomes thereafter.

*Conclusions: Dual kidney transplantation after sequence 100 in the match run is associated with longer cold ischemic times and delayed graft function with comparable graft function post transplantation. Dual kidney transplantation (HTPDKT) allows acceptance of an organ offer for marginal kidneys low on the match run without compromising graft survival.

« Back to 2022 American Transplant Congress