Dual kidney transplant techniques: A systematic review

Clin Transplant. 2017 Aug;31(8). doi: 10.1111/ctr.13016. Epub 2017 Jun 23.

Abstract

Background: Dual kidney transplantation (DKT) was developed to improve outcomes from transplantation of extended criteria donors (ECD). This study examined which surgical techniques have been reported for DKT and whether any technique had superior patient and graft survival.

Method: Electronic databases were searched for published studies mapping to MESH terms: "kidney or renal" AND "transplan*" AND "dual or double." Single case reports, studies of patients less than 18 years old, studies which did not describe the surgical technique, and studies that did not report patient or graft survival were excluded.

Results: Fifteen reports of 434 DKT recipients were identified. Three techniques were described: bilateral placement; unilateral placement with separate anastomoses; and unilateral placement with patch anastomoses. Patient survival across all three techniques was over 95% at 1 year, and graft survival was also similar at over 90%. Rates of delayed graft function were between 20% and 30% across all techniques.

Conclusion: The three techniques have equivalent delayed graft function as well as patient and graft survival rates. This is an encouraging result as it means that the surgeon can choose to use the technique which is most appropriate for their own skills and for the patient.

Keywords: dual kidney transplant; kidny transplantation; renal transplantation.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Delayed Graft Function
  • Graft Survival
  • Humans
  • Kidney Transplantation / methods*
  • Kidney Transplantation / mortality
  • Operative Time
  • Outcome Assessment, Health Care
  • Postoperative Complications