Presentation Authors: Lionel Mendel*, Imad Bentellis, Thierry Yandza, Laetitia Albano, Jean Amiel, Daniel Chevallier, Matthieu Durand, Nice, France
Introduction: Dual kidney transplantation (DKT) is an underused way to address graft shortage, allowing elderly patients to get quickly a kidney transplant. The choice between the ipsilateral (IDKT) method, maintaining the controlateral iliac fossa and the bilateral (BDKT) method, sometimes considered safer is still debated. The aim was to report our centerâ€™s experience regarding these two approaches.
Methods: All of DKT indicated according to the BIGRE criteria protocol led by the french national Agence de la BiomÃ©decine performed in our institution from february 2006 and june 2014 were retrospectively reviewed. Demographic and peri-operative data, all surgical revisions and functional outcomes were collected and analyzed to compare IDKT and BDKT. The main evaluation criterion was the early (â‰¤ 1month) surgical revisions rate. To compare quantitative and qualitative variables, the Student t, Mann-Whitney and Chi square tests were used.
Results: Thirty nine DKT were included with a median follow-up of 36 months. Operating time and warm ischemic time of the second transplanted graft were significantly longer with BDKT (respectively 272,3 Â±76,9 vs 219,5 Â±29,5 mn, p=0,0042 and 48,1 Â±12,5 vs 38,9 Â±10,3 mn, p=0,0244) [Table 1]. Early surgical revision rates were not significantly different between the two groups but more surgical revisions for hematomas occured in BDKT group (33,3 % vs 4,2 %, p=0,0236) [Table 2]. One death directly related to transplantation was reported with BDKT. No eventration was reported in BDKT versus 3 (12,5%) in IDKT (p=0,2713). Explantation rates, serum creatinine and glomerular filtration rates were not significantly different between the two groups.
Conclusions: In our series, there is no major significant difference between BDKT and IDKT regarding safety and functional outcomes. Even if these results need a confirmation, it appears crucial to include surgeon experience and patient characteristics in the choice of IDKT or BDKT technics.