Double kidney transplantation: initial experience of the Bologna Transplant Center.
OBJECTIVE
Double-kidney transplantation is performed using organs from marginal donors with a histological score not suitable for single kidney transplantation. The aim of the study is to verify the results obtained with double-kidney transplantation in terms of graft and patient survival and complications.


METHODS
Between September 2001 and September 2004, 16 double-kidney transplantations were performed in our center. The kidneys were all perfused with Celsior solution and the mean cold ischemia time was 17.6+/-2.7 hours. In all cases a pre-transplant kidney biopsy was performed to evaluate the damage. Immunosuppression was tacrolimus based for all patients.


RESULTS
Eight patients had good renal postoperative function while the other eight had acute tubular necrosis. Two of the patients who had severe acute tubular necrosis never recovered renal function. There was only one episode of acute rejection, while the incidence of urinary complications was 31.2%; there were two surgical revisions for intestinal perforation. The graft and recipient survival was 78.1% and 100% and 78.1% and 93.7% at 3 and 36 months.


CONCLUSIONS
Double-kidney transplantation is a safe way to face the organ shortage. Moreover the score used in this study is useful to determine whether a kidney should be refused or suitable for single or dual-kidney transplantation. The results of our initial experience are encouraging, but this series is too small in number to consent a conclusive statement.
Nardo
B
B
Department of Surgery, Intensive Care Unit and Transplantations, S. Orsola Hospital, University of Bologna, Bologna, Italy. nardo@aosp.bo.it
Pacilè
V
V
Bertelli
R
R
Beltempo
P
P
Montalti
R
R
Puviani
L
L
Neri
F
F
Mosconi
G
G
Scolari
M P
MP
Liviano D'Arcangelo
G
G
Stefoni
S
S
Faenza
A
A
D000368:Aged; D005260:Female; D006085:Graft Survival; D006801:Humans; D007558:Italy; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D007683:Kidney Tubular Necrosis, Acute / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function