Multicenter study on double kidney transplantation
| Autor: | Giuseppe Cavallari, Ad Pinna, Sergio Stefoni, Giovanni Fuga, N. Busi, Alberto Albertazzi, Enzo Capocasale, L. Benozzi, Riccardo Bertelli, Bruno Nardo, R. Dalla Valle, Chiara Gilioli, Alessandro Faenza, M.P. Mazzoni, Gianni Cappelli |
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| Přispěvatelé: | Bertelli R, Nardo B, Capocasale E, Cappelli G, Cavallari G, Mazzoni MP, Benozzi L, Dalla Valle R, Fuga G, Busi N, Gilioli C, Albertazzi A, Stefoni S, Pinna AD, Faenza A. |
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Perforation (oil well) Renal function Functional Laterality Nephropathy Lymphocele Postoperative Complications medicine Humans Dialysis Kidney transplantation Retrospective Studies Transplantation business.industry Histocompatibility Testing Patient Selection Middle Aged medicine.disease Kidney Transplantation Surgery Treatment Outcome Marginal organs kidney transplantat long-term outcomes Kidney Diseases business Kidney disease Follow-Up Studies |
| Popis: | Background Marginal organs not suitable for single kidney transplantation are considered for double kidney transplantation (DKT). Herein we have reviewed short and long-term outcomes of DKT over a 7-year experience. Patients and Methods Between 2001 and 2007, 80 DKT were performed in the transplant centers of Bologna, Parma, and Modena, Italy. Recipient mean age was 61 ± 5 years. The main indications were glomerular nephropathy (n = 33) and hypertensive nephroangiosclerosis (n = 14). Mean HLA A, B, and DR mismatches were 3.1 ± 1.2. Donor mean age was 69 ± 8 years and mean creatinine clearance was 75 ± 27 mL/min. Almost all kidneys were perfused with Celsior solution. Mean cold ischemia time was 17 ± 4 hours and mean warm ischemia time was 41 ± 17 minutes. Mean biopsy score was 4.4. Immunosuppression was based on tacrolimus (n = 52) or cyclosporine (n = 26). Results Fifty (62.5%) patients displayed good postoperative renal function. Thirty (37.5%) experienced acute tubular necrosis and required postoperative dialysis treatment; 8 acute rejections occurred. Urinary complications were 13.7% with 8/11 requiring surgical revision. There were 6 surgical reexplorations: intestinal perforation (n = 2), bleeding (n = 3), and lymphocele (n = 1). Two patients lost both grafts due to vascular and infectious complications at 7 or 58 days after transplantation. Two patients underwent intraoperative transplantectomy due to massive vascular thrombosis. Four (5%) patients underwent transplantectomy of a single graft due to vascular complications (n = 2), bleeding (n = 1), or infectious complications (n = 1). Graft and patient survivals were 95% and 100% versus 93% and 97% at 3 versus 36 months, respectively. Conclusions DKT is a safe approach for organ shortage. The score used in this study is useful to determine whether a kidney should be refused or accepted. |
| Databáze: | OpenAIRE |
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