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dc.contributor.authorD'Arcy, Frank T
dc.contributor.authorO'Connor, Kevin M
dc.contributor.authorShields, William
dc.contributor.authorZimmerman, Jose A
dc.contributor.authorMohan, Ponnusamy
dc.contributor.authorEng, Molly
dc.contributor.authorLittle, Dilly M
dc.contributor.authorPower, Richard
dc.contributor.authorDorman, Anthony
dc.contributor.authorHickey, David P
dc.date.accessioned2011-04-06T14:17:12Z
dc.date.available2011-04-06T14:17:12Z
dc.date.issued2009-10
dc.identifier.citationDual kidney transplantation with organs from extended criteria cadaveric donors. 2009, 182 (4):1477-81 J. Urol.en
dc.identifier.issn1527-3792
dc.identifier.pmid19683744
dc.identifier.doi10.1016/j.juro.2009.06.021
dc.identifier.urihttp://hdl.handle.net/10147/127486
dc.description.abstractThe critical shortage of kidneys available for transplantation has led to alternate strategies to expand the pool. Transplantation of the 2 kidneys into a single recipient using organs suboptimal for single kidney transplantation was suggested. We assessed results in 24 grafts allocated for dual kidney transplantation vs those in a control group of 44 designated for single kidney transplantation. Each group underwent pretransplant biopsy and recipients were age matched.
dc.description.abstractDual kidney transplantation was done in 24 of 1,091 transplants (2.1%) from 2001 to 2008. In patients with dual kidney transplant vs single kidney transplant mean recipient age was 60.6 vs 60.8 years, mean HLA-A, B and DR mismatches were 3.3 vs 2.9, and average patient waiting time was 15.6 vs 13.9 months. All grafts were perfused with University of Wisconsin solution with a mean cold ischemia time of 17.9 hours. On donor dual kidney biopsy in the dual kidney transplant vs single kidney transplant group the average fibrosis rate was 30% (range 25% to 45%) vs 25% (range 3% to 40%) and the glomerulosclerosis rate was 17.9% (range 3.2% to 40.7%) vs 7.1% (range 0% to 50%).
dc.description.abstractGood postoperative renal function was noted in 14 dual kidney transplantation cases. Acute tubular necrosis requiring dialysis developed in 5 patients as well as acute rejection in 1. Two dual kidney recipients (8%) died in the postoperative period with no single kidney deaths. One patient underwent bilateral transplantectomy. Mean anesthesia time was longer in the dual group (371 vs 212 minutes). Patient and graft survival was equivalent to that in the control group at 36 months.
dc.description.abstractCareful selection of marginal kidneys based on clinical and histological criteria allows the use of organs that would not ordinarily be sufficient for transplantation with acceptable outcomes. This is a valid strategy to address the organ shortage.
dc.language.isoenen
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshCadaver
dc.subject.meshHumans
dc.subject.meshKidney Transplantation
dc.subject.meshMiddle Aged
dc.subject.meshTissue Donors
dc.subject.meshTissue and Organ Procurement
dc.titleDual kidney transplantation with organs from extended criteria cadaveric donors.en
dc.typeArticleen
dc.contributor.departmentNational Kidney and Pancreas Transplantation Unit, Beaumont Hospital, Dublin, Ireland. darcyft@hotmail.comen
dc.identifier.journalThe Journal of urologyen
dc.description.provinceLeinster
html.description.abstractThe critical shortage of kidneys available for transplantation has led to alternate strategies to expand the pool. Transplantation of the 2 kidneys into a single recipient using organs suboptimal for single kidney transplantation was suggested. We assessed results in 24 grafts allocated for dual kidney transplantation vs those in a control group of 44 designated for single kidney transplantation. Each group underwent pretransplant biopsy and recipients were age matched.
html.description.abstractDual kidney transplantation was done in 24 of 1,091 transplants (2.1%) from 2001 to 2008. In patients with dual kidney transplant vs single kidney transplant mean recipient age was 60.6 vs 60.8 years, mean HLA-A, B and DR mismatches were 3.3 vs 2.9, and average patient waiting time was 15.6 vs 13.9 months. All grafts were perfused with University of Wisconsin solution with a mean cold ischemia time of 17.9 hours. On donor dual kidney biopsy in the dual kidney transplant vs single kidney transplant group the average fibrosis rate was 30% (range 25% to 45%) vs 25% (range 3% to 40%) and the glomerulosclerosis rate was 17.9% (range 3.2% to 40.7%) vs 7.1% (range 0% to 50%).
html.description.abstractGood postoperative renal function was noted in 14 dual kidney transplantation cases. Acute tubular necrosis requiring dialysis developed in 5 patients as well as acute rejection in 1. Two dual kidney recipients (8%) died in the postoperative period with no single kidney deaths. One patient underwent bilateral transplantectomy. Mean anesthesia time was longer in the dual group (371 vs 212 minutes). Patient and graft survival was equivalent to that in the control group at 36 months.
html.description.abstractCareful selection of marginal kidneys based on clinical and histological criteria allows the use of organs that would not ordinarily be sufficient for transplantation with acceptable outcomes. This is a valid strategy to address the organ shortage.


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