PMID- 25297945
OWN - NLM
STAT- MEDLINE
DCOM- 20150825
LR  - 20141208
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 28
IP  - 12
DP  - 2014 Dec
TI  - A single-center experience with 200 dual kidney transplantations.
PG  - 1433-40
LID - 10.1111/ctr.12475 [doi]
AB  - This study reports on a large series of 200 dual kidney transplantations (DKTs) 
      from expanded criteria donors (ECDs) and proposes specific ways to optimize 
      outcomes. Data concerning 200 DKTs performed in the last 14 yr were 
      retrospectively analyzed. Kidneys from high-risk ECD were allocated for use in 
      DKTs on an old-for-old basis after histological assessment. Different surgical 
      techniques and immunosuppressant regimens were used over time, and the outcomes 
      are discussed. Donors and recipients were a median 73 (70-77) and a 62 (58-67) yr 
      old, respectively. Delayed graft function occurred in 31.5% of cases, and acute 
      rejection in 13.5%. Patient and graft survival at five yr were 90.4% and 85.8%, 
      respectively. Unilateral kidney placement was preferred for 75% of patients, and 
      was associated with a low rate of surgical complications. Our current standard 
      therapy comprising low-dose calcineurin inhibitors (CNIs) associated with 
      mammalian target of rapamycin inhibitors (mTOR) and steroids appears to offer the 
      best risk/benefit profile for elderly patients undergoing DKT. In our experience, 
      outcomes after DKT can be improved by: (i) kidney clinical-histological 
      assessment; (ii) unilateral kidney placement; (iii) minimal use of CNI associated 
      with mTOR.
CI  - (c) 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Rigotti, Paolo
AU  - Rigotti P
AD  - Kidney and Pancreas Transplantation Unit, Department of Surgical, Oncological and 
      Gastroenterological Sciences, Padua University Hospital, University of Padua, 
      Padua, Italy.
FAU - Capovilla, Giovanni
AU  - Capovilla G
FAU - Di Bella, Caterina
AU  - Di Bella C
FAU - Silvestre, Cristina
AU  - Silvestre C
FAU - Donato, Paola
AU  - Donato P
FAU - Baldan, Nicola
AU  - Baldan N
FAU - Furian, Lucrezia
AU  - Furian L
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20141104
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Glomerular Filtration Rate
MH  - Graft Survival
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Kidney Failure, Chronic/*surgery
MH  - Kidney Function Tests
MH  - Kidney Transplantation/*methods/mortality
MH  - Male
MH  - Middle Aged
MH  - *Postoperative Complications
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Tissue Donors/*statistics & numerical data
MH  - Tissue and Organ Harvesting/*methods
OTO - NOTNLM
OT  - donor selection
OT  - dual kidney transplantation
OT  - immunosuppressant therapy
OT  - surgical technique
EDAT- 2014/10/10 06:00
MHDA- 2015/08/26 06:00
CRDT- 2014/10/10 06:00
PHST- 2014/10/03 00:00 [accepted]
PHST- 2014/10/10 06:00 [entrez]
PHST- 2014/10/10 06:00 [pubmed]
PHST- 2015/08/26 06:00 [medline]
AID - 10.1111/ctr.12475 [doi]
PST - ppublish
SO  - Clin Transplant. 2014 Dec;28(12):1433-40. doi: 10.1111/ctr.12475. Epub 2014 Nov 
      4.