39th National Congress of the Italian Society of Organ TransplantationRenal transplantationExpanded Criteria Donor Kidney Transplantation: Comparative Outcome Evaluation Between Single Versus Double Kidney Transplantation at 8 Years: A Single Center Experience
Section snippets
Patients and Methods
From May 2007 to April 2015, 99 (36.5%) kidney transplantation as determined according UNOS criteria, including 67 single (SKT) and 32 dual kidneys transplantation (DKT) among an overall experience of 271 cadaveric transplants were performed in the POIT (Polo Ospedaliero Interaziendale Trapianti) Transplant Center in Rome, Italy. The remaining 172 cases were standard criteria transplants. Perfusion in situ used Celsior solution. The candidates on the waiting list are characterized according to
Results
The characteristics of the donors in the two groups were similar in terms of gender, body mass index, cold ischemia time, serum creatinine levels, estimated glomerular filtration rate according to MDRD formula. We observed statistically significant differences between the two groups in the following characteristics: donor age (P < .001), histological score (P < .001), estimated glomerular filtration rate according to Cockroft-Gault formula (P < .04). The characteristics of recipients (SKT vs
Discussion
By expanding the pool of criteria donors, the number of kidney transplantations can increase. We chose to utilize a single kidney from ECD with a good renal function and Karpinsky score of ≤4, we used a score of ≥5 to determine DKT, in a middle and long-term observation confirmed by good results in the literature [8], [9]. In our study, some points merit comments. In donor characteristics, we found statistically significant differences between the two groups in donor age and Karpinsky score,
Conclusion
Several strategies have been implemented to satisfy the demand for more kidney transplantations. One such strategy involves the use of expanded criteria donor kidneys allocated for single or dual grafts place in one recipient. Our decision to allocate grafts based on Karpinsky score (≤4 for SKT and ≥5 for DKT), but above all on creatinine levels at the time of procurement, confirmed a good results of literature data. Our local experience showed similar graft and patient survival in the middle
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Post-kidney donation glomerular filtration rate measurement and estimation
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