Dual Kidney Transplantation: Evaluation of Recipient Selection Criteria at Niguarda Hospital.
BACKGROUND
Dual kidney transplantation (DKT) is a largely accepted strategy to enlarge the donor pool. Niguarda Hospital started this program in December 2010, and 38 DKT have been performed. In our series, we included recipients older than those in the other series published in literature. The aim of this study was to know if our recipient selection criteria for DKT are safe.


METHODS
We reviewed our data base of DKT and analyzed recipients' medical history, surgical technique, post-operative complications, graft survival, morbidity, and mortality. We then compared our results with the literature.


RESULTS
From December 2010 to April 2015, 38 DKT were performed in Niguarda Hospital. Delayed graft function was present in 21 recipients. Explantation of both kidneys was performed in 1 patient and explantation of 1 kidney in 6 patients. Post-operative complications were present in 8 patients. Five patients returned to hemodialysis after DKT. One recipient died of medical post-operative sepsis. The mean follow-up was 24 months. Graft survival and patient survival were 86.84% and 97.93%, respectively. Compared with the literature, our series had similar mortality and morbidity rates, even if recipients' age was higher than in other series.


CONCLUSIONS
The strategy of DKT allocation in elderly recipients is safe. Further studies have to be performed to optimized selection of the recipients for DKT not to disadvantage younger patients in the transplant waiting list and to improve the technique of organ evaluation and preservation to refine graft allocation.
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy. Electronic address: anna.mariani@ospedaleniguarda.it.
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Mariani
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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Ferla
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy; Department of Surgical Sciences, University of Pavia, Pavia, Italy.
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De Carlis
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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Rossetti
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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Covucci
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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Tripepi
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy; Department of Surgical Sciences, University of Pavia, Pavia, Italy.
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Concone
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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Lauterio
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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Mangoni
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
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De Carlis
D000367:Age Factors; D000368:Aged; D051799:Delayed Graft Function / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006085:Graft Survival; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014019:Tissue Donors / Q000600:supply & distribution