Mariani A, Ferla F, De Carlis R, Rossetti O, Covucci E, Tripepi M, Concone G, Lauterio A, Mangoni I, De Carlis L
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
Department of General Surgery and Transplantation, Niguarda Hospital, Milan, Italy.
Transplant Proc. 2016 Mar;48(2):315-8. doi: 10.1016/j.transproceed.2015.12.041.
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.
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.
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.
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.
双肾移植（DKT）是一种被广泛接受的扩大供体库的策略。尼瓜尔达医院于2010年12月启动了该项目，已进行了38例双肾移植手术。在我们的系列研究中，纳入的受者年龄比文献中发表的其他系列研究中的受者年龄更大。本研究的目的是了解我们双肾移植受者的选择标准是否安全。
我们回顾了双肾移植的数据库，并分析了受者的病史、手术技术、术后并发症、移植物存活情况、发病率和死亡率。然后我们将我们的结果与文献进行了比较。
2010年12月至2015年4月，尼瓜尔达医院进行了38例双肾移植手术。21例受者出现移植肾功能延迟恢复。1例患者进行了双侧肾脏切除，6例患者进行了单侧肾脏切除。8例患者出现术后并发症。5例患者双肾移植后恢复血液透析。1例受者死于术后感染性败血症。平均随访时间为24个月。移植物存活率和患者存活率分别为86.84%和97.93%。与文献相比，即使我们系列研究中的受者年龄高于其他系列研究中的受者，我们系列研究中的死亡率和发病率相似。
老年受者双肾移植分配策略是安全的。必须进行进一步研究，以优化双肾移植受者的选择，避免使移植等待名单上的年轻患者处于不利地位，并改进器官评估和保存技术以优化移植物分配。
