Dual kidney transplants from adult marginal donors successfully expand the limited deceased donor organ pool

Clinical Transplantation
Robert J StrattaJeffrey Rogers

Abstract

The need to expand the organ donor pool remains a formidable challenge in kidney transplantation (KT). The use of expanded criteria donors (ECDs) represents one approach, but kidney discard rates are high because of concerns regarding overall quality. Dual KT (DKT) may reduce organ discard and optimize the use of kidneys from marginal donors. We conducted a single-center retrospective review of outcomes in adult recipients of DKTs from adult marginal deceased donors (DD) defined by limited renal functional capacity. If the calculated creatinine clearance in an adult DD was <65 mL/min, then the kidneys were transplanted as a DKT. Over 11.5 yr, 72 DKTS were performed including 45 from ECDs, 17 from donation after cardiac death (DCD) donors, and 10 from standard criteria donors (SCD). Mean adult DD and recipient ages were both 60 yr, including 29 DDs and 26 recipients ≥65 yr of age. Mean pre-DKT waiting and dialysis vintage times were 12 months and 25 months, respectively. Actual patient and graft survival rates were 84.7% and 70.8%, respectively, with a mean follow-up of 58 months. One yr and death-censored graft survival rates were 90% and 80%, respectively. Outcomes did not differ by DD category, recipient age, or presence of d...Continue Reading

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Citations

Oct 11, 2016·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·R ThuretM O Timsit
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May 8, 2018·Kidney International·Sumit MohanDavid J Cohen
Dec 24, 2021·Current Opinion in Organ Transplantation·Robert J StrattaBerjesh Sharda

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