Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique
Background. Acceptance of dual kidney transplantation (DKT) has proven difficult, due to surgical complexity and concerns regarding long-term outcomes. We herein present a standard technique for ipsilateral DKT and compare outcomes to single-kidney transplant (SKT) recipients. Methods. A retrospecti...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2016/2586761 |
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| author | Ana K. Islam Richard J. Knight Wesley A. Mayer Adam B. Hollander Samir Patel Larry D. Teeter Edward A. Graviss Ashish Saharia Hemangshu Podder Emad H. Asham A. Osama Gaber |
| author_facet | Ana K. Islam Richard J. Knight Wesley A. Mayer Adam B. Hollander Samir Patel Larry D. Teeter Edward A. Graviss Ashish Saharia Hemangshu Podder Emad H. Asham A. Osama Gaber |
| author_sort | Ana K. Islam |
| collection | DOAJ |
| description | Background. Acceptance of dual kidney transplantation (DKT) has proven difficult, due to surgical complexity and concerns regarding long-term outcomes. We herein present a standard technique for ipsilateral DKT and compare outcomes to single-kidney transplant (SKT) recipients. Methods. A retrospective single-center comparison of DKT and SKT performed between February 2007 and July 2013. Results. Of 516 deceased donor kidney transplants, 29 were DKT and 487 were SKT. Mean follow-up was 43 ± 67 months. DKT recipients were older and more likely than SKT recipients to receive an extended criteria graft (p<0.001). For DKT versus SKT, the rates of delayed graft function (10.3 versus 9.2%) and acute rejection (20.7 versus 22.4%) were equivalent (p = ns). A higher than expected urologic complication rate in the DKT cohort (14 versus 2%, p<0.01) was reduced through modification of the ureteral anastomosis. Graft survival was equivalent between DKT and SKT groups (p = ns) with actuarial 3-year DKT patient and graft survivals of 100% and 93%. At 3 years, the groups had similar renal function (p = ns). Conclusions. By utilizing extended criteria donor organs as DKT, the donor pool was enlarged while providing excellent patient and graft survival. The DKT urologic complication rate was reduced by modification of the ureteral anastomosis. |
| format | Article |
| id | doaj-art-e7ba3493ea164a949e136886d00476ce |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-e7ba3493ea164a949e136886d00476ce2025-02-03T01:25:30ZengWileyJournal of Transplantation2090-00072090-00152016-01-01201610.1155/2016/25867612586761Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical TechniqueAna K. Islam0Richard J. Knight1Wesley A. Mayer2Adam B. Hollander3Samir Patel4Larry D. Teeter5Edward A. Graviss6Ashish Saharia7Hemangshu Podder8Emad H. Asham9A. Osama Gaber10Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Surgery, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Urology, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Pharmacy, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Pathology & Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Pathology & Genomic Medicine, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Surgery, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Surgery, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Surgery, Houston Methodist Hospital, Houston, TX 77030, USADepartment of Surgery, Houston Methodist Hospital, Houston, TX 77030, USABackground. Acceptance of dual kidney transplantation (DKT) has proven difficult, due to surgical complexity and concerns regarding long-term outcomes. We herein present a standard technique for ipsilateral DKT and compare outcomes to single-kidney transplant (SKT) recipients. Methods. A retrospective single-center comparison of DKT and SKT performed between February 2007 and July 2013. Results. Of 516 deceased donor kidney transplants, 29 were DKT and 487 were SKT. Mean follow-up was 43 ± 67 months. DKT recipients were older and more likely than SKT recipients to receive an extended criteria graft (p<0.001). For DKT versus SKT, the rates of delayed graft function (10.3 versus 9.2%) and acute rejection (20.7 versus 22.4%) were equivalent (p = ns). A higher than expected urologic complication rate in the DKT cohort (14 versus 2%, p<0.01) was reduced through modification of the ureteral anastomosis. Graft survival was equivalent between DKT and SKT groups (p = ns) with actuarial 3-year DKT patient and graft survivals of 100% and 93%. At 3 years, the groups had similar renal function (p = ns). Conclusions. By utilizing extended criteria donor organs as DKT, the donor pool was enlarged while providing excellent patient and graft survival. The DKT urologic complication rate was reduced by modification of the ureteral anastomosis.http://dx.doi.org/10.1155/2016/2586761 |
| spellingShingle | Ana K. Islam Richard J. Knight Wesley A. Mayer Adam B. Hollander Samir Patel Larry D. Teeter Edward A. Graviss Ashish Saharia Hemangshu Podder Emad H. Asham A. Osama Gaber Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique Journal of Transplantation |
| title | Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique |
| title_full | Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique |
| title_fullStr | Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique |
| title_full_unstemmed | Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique |
| title_short | Intermediate-Term Outcomes of Dual Adult versus Single-Kidney Transplantation: Evolution of a Surgical Technique |
| title_sort | intermediate term outcomes of dual adult versus single kidney transplantation evolution of a surgical technique |
| url | http://dx.doi.org/10.1155/2016/2586761 |
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