Two-as-one monolateral dual kidney transplantation.
OBJECTIVE
Dual kidney transplantation (DKT) of marginal kidneys could offer transplant candidates a very satisfactory kidney transplantation in terms of renal function. However, DKT might be considered a major surgical procedure and, in older recipients, has a potentially greater risk of surgical complications compared with single kidney transplantation. Because of these findings, some transplant centers have replaced the classic bilateral placement of 2 kidneys with the monolateral placement of both kidneys.


METHODS
In a group of 35 DKTs performed during a 5-year period, we applied a new technique of monolateral placement of DKT in 10 recipients. In these 10 patients, the arteries and veins of the 2 kidneys were joined through a running suture, and the joined kidneys were anastomosed into the external iliac vessels in the recipient.


RESULTS
The delayed graft function rate was 20%. No surgical complications developed in the entire series. One patient experienced late rejection with ureteral stricture. The graft and patient survival rate at a median follow-up of 30 months was 90%.


CONCLUSIONS
To reduce the surgical risk and morbidity rate, the monolateral placement of both kidneys seems the safest method to perform DKT. The joined monolateral DKT, by reducing the cold ischemia time and the surgical trauma, could represent a step forward in the delicate treatment of these patients.
Veroux
Pierfrancesco
P
Department of Surgery, Transplantation and Advanced Technologies, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy. veroux@unict.it
Giuffrida
Giuseppe
G
Cappellani
Alessandro
A
Caglià
Pietro
P
Palmucci
Stefano
S
Sorbello
Massimiliano
M
Puzzo
Lidia
L
Veroux
Massimiliano
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged