title: Analysis of 80 dual-kidney transplantations: a multicenter experience.
abstract: BACKGROUND
  The use of kidneys from expanded criteria donors (ECD) is an attractive strategy to enlarge the pool of organs available for transplantation. Considering the fact that ECD organs have a reduced nephron mass, they are preferentially allocated for dual-kidney transplantation (DKT). Authors have reported excellent results of DKT when pretransplant ECD organs are evaluated for histological scores. The aim of this study was to evaluate DKT donor and recipient characteristics for comparison with DKT posttransplant outcomes versus those of recipients of single-kidney transplantations from expanded criteria (edSKT) and ideal donors (idSKT). We analyzed the potential prognostic factors involved in DKT among a population derived from three transplant centers.
  
  
  METHODS
  Between 2001 and 2007, DKT (n = 80) were performed based upon the ECD kidney allocation assessed by biopsy.
  
  
  RESULTS
  The average donor ages for the DKT, edSKT, and idSKT groups were 68.8 ± 7.8, 65.3 ± 7.2, and 40.1 ± 13.8 years, respectively (P < .001). The number of human leukocyte antigen mismatches was greater in the DKT group (3.1 ± 1.2, P < .05). Patient and graft 5-year survival rates were similar among DKT, edSKT, and idSKT recipients, namely, 97.5% versus 95.8% versus 96.9% and 93.7% versus 87.4% versus 86.9%, respectively. Mean serum creatinine values at discharge were lower in the DKT and idSKT recipients (1.5 ± 0.9 and 1.6 ± 0.7 mg/dL; P < .05) compared with the edSKT group (1.9 ± 0.7 mg/dL). Correlations between supposed prognostic factors and survival among the DKT group noted worse outcomes in reoperation cases (P < .05).
  
  
  CONCLUSIONS
  We confirmed that DKT produced successful outcomes. An accurate surgical procedure is particularly important to try to avoid reoperations. In our experience, the use of a biopsy as an absolute criterion to allocate ECD kidneys may be too protective.
authors.affiliation: Department of General Surgery and Transplantation University of Bologna, Bologna, Italy. b.nardo@libero.it
authors.forename: B
authors.initials: B
authors.lastname: Nardo
authors.forename: R
authors.initials: R
authors.lastname: Bertelli
authors.forename: G
authors.initials: G
authors.lastname: Cavallari
authors.forename: E
authors.initials: E
authors.lastname: Capocasale
authors.forename: G
authors.initials: G
authors.lastname: Cappelli
authors.forename: M P
authors.initials: MP
authors.lastname: Mazzoni
authors.forename: L
authors.initials: L
authors.lastname: Benozzi
authors.forename: R
authors.initials: R
authors.lastname: Dalla Valle
authors.forename: G
authors.initials: G
authors.lastname: Fuga
authors.forename: N
authors.initials: N
authors.lastname: Busi
authors.forename: C
authors.initials: C
authors.lastname: Gilioli
authors.forename: A
authors.initials: A
authors.lastname: Albertazzi
authors.forename: S
authors.initials: S
authors.lastname: Stefoni
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
authors.forename: A
authors.initials: A
authors.lastname: Faenza
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine