Unilateral vs. Bilateral Dual Kidney Transplantation: University of Bologna Experience
1Organ Insufficency and Transplantation/Transplantation Unit Prof. A.D. Pinna, S.Orsola Malpighi Hospital University of Bologna, Bologna, Italy
2Organ Insufficency and Transplantation Nephrology Unit G. La Manna, S.Orsola Malpighi Hospital University of Bologna, Bologna, Italy
3Organ Insufficency and Transplantation Intensive Care Unit Prof. S. Faenza, S.Orsola Malpighi Hospital University of Bologna, Bologna, Italy
4Organ Insufficency and Transplantation Pathology Unit D'Errico, S.Orsola Malpighi Hospital University of Bologna, Bolgona, Italy.
Meeting: 2018 American Transplant Congress
Abstract number: C166
Keywords: Biopsy, Donors, Graft function, Graft survival, marginal
Session Information
Session Name: Poster Session C: Kidney Technical
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
One option for using organs from donors with a suboptimal nephron mass, e.g. expanded criteria donors (ECD) kidneys, is dual kidney transplantation (DKT)
Methods: Ninety-three DKT were performed, among January 2006 until November 2017, using kidneys from ECD donors. The results of unilateral DKT (UDKT, group 1 n=34) in same iliac fossa were compared with a cohort of DKT performed with bilateral placement of each kidney (BDKT) with the same donor and recipient selection criteria in the same study period (Group 2, n = 59). No difference among groups in term of donor sex, age, BMI, Karpinsky score, cause of donor death; no difference also in term of recipient sex, median age, BMI, start of dyalisis, presence of diabetes, vascular calcification and cardiac diseases.
Results: All vascular anastomoses were to the external iliac vessels end-to-side in the UDKT group. Mean operating time was shorter in UDKT group (319 minutes vs 733, p< 0.0001), second kidney graft ischemia time was shorter in UDKT group (740 minutes vs 997). Surgical complications were comparable in both groups in term of ureteral stenosis (4.3% vs 3.3%, p=0.05), venous thrombosis (0% vs 1.9%, p=0.05), arterial thrombosis (0% vs 1.9%, P=0.05) but in the UDKT group the incidence of ureteral fistula was higher (8.6% vs 5.08%, p=0.04). At 3-year follow-up, patient and graft survival rates were 100% and 100%% in Group 1, and 98% and 93% in Group 2, respectively. The incidence of delay graft function was 13% vs 25% (p=0.04) in the Group 1 and 2, respectively.
Conclusion: UDKT can be carried out with comparable surgical complication rates as BDKT, leaving the contralateral iliac fossa untouched and giving elderly recipients a better chance of receiving a transplant, with optimal results up to 3-years follow-up.
CITATION INFORMATION: Del Gaudio M., Ravaioli M., Zanfi C., Bertuzzo V., Maroni L., La Manna G., Liviano G., Siniscalchi A., D'Errico A., Pinna A. Unilateral vs. Bilateral Dual Kidney Transplantation: University of Bologna Experience Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Gaudio MDel, Ravaioli M, Zanfi C, Bertuzzo V, Maroni L, Manna GLa, Liviano G, Siniscalchi A, D'Errico A, Pinna A. Unilateral vs. Bilateral Dual Kidney Transplantation: University of Bologna Experience [abstract]. https://atcmeetingabstracts.com/abstract/unilateral-vs-bilateral-dual-kidney-transplantation-university-of-bologna-experience/. Accessed May 7, 2025.« Back to 2018 American Transplant Congress