Single graft loss in dual renal transplant recipients: impact of graft placement on recipient outcomes |
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Authors: | Marc‐Olivier Timsit Marion Rabant Renaud Snanoudj Daniel Cohen Ambroise Salin Sayeed Malek Yannick Rouach Henri Kreis Christophe Legendre Arnaud Mejean |
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Institution: | 1. Université Paris Descartes, Paris, France;2. Department of Urology and Renal Surgery, Georges Pompidou – European Hospital (HEGP) and Necker Hospital, AP‐HP, Paris, France;3. Division of Nephrology and Transplantation, Necker Hospital, Paris, France;4. Division of Transplant Surgery, Brigham and Women’s Hospital, Boston, MA, USA |
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Abstract: | We aimed to assess the impact of graft placement in dual renal transplantation on the risk for single graft loss and to report recipient outcomes. Between 2004 and 2007, 55 dual renal transplants were performed at our institution. Allografts were placed bilaterally (one in each iliac fossa) in 42 patients and unilaterally (both in the same iliac fossa) in 14 patients. Nine recipients (16.4%) underwent explantation of a single graft as a consequence of vascular thrombosis designated as the SINGLE group, whereas 46 had two functional allografts (DUAL group). There was a higher rate of graft loss in case of unilateral placement (n = 5/14) compared with bilateral placement (n = 4/41) (35.7% vs. 9.8%, P = 0.035). One‐year glomerular filtration rate was significantly lower in the SINGLE group (29.4 ml/min/1.73 m2 vs. 49.4 ml/min/1.73 m2 in the DUAL group, P < 0.05). Significantly, none of the nine recipients of the SINGLE group returned to dialysis with a mean follow‐up of 34.1 months. Graft survival at 1 year was 100% and 97.9% in SINGLE and DUAL groups, respectively. Unilateral placement of both allografts is associated with an increased risk of single graft loss and therefore lower renal function at 1 year. However, this strategy is safe in selected indications. |
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Keywords: | age human kidney transplantation/methods patients’ outcome surgical complication |
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