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Kute VB, Patel HV, Modi PR, Rizvi SJ, Shah PR, Engineer DP, Banerjee S, Butala BP, Gandhi S, Mishra VV. Two Decades of Deceased Donor Kidney Transplantation at Ahmedabad, India. EXP CLIN TRANSPLANT 2020; 18:549-556. [PMID: 33143600 DOI: 10.6002/ect.2020.0318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wang Z, Durai P, Tiong HY. Expanded criteria donors in deceased donor kidney transplantation - An Asian perspective. Indian J Urol 2020; 36:89-94. [PMID: 32549658 PMCID: PMC7279103 DOI: 10.4103/iju.iju_269_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 01/29/2023] Open
Abstract
There is an increasing gulf between demand and supply for kidneys in end-stage renal failure patients worldwide, especially Asia. Renal transplantation is often the treatment of choice for long-suffering patients who have to undergo dialysis on a regular basis. The utilization of expanded criteria donors (ECDs) to address the donor pool shortage has been proven to be a legitimate solution. Metzger first described the classification of standard criteria donor and ECD in 2002. Since then, the criterion has undergone various modifications, with the key aims of optimizing organ procurement rate while minimizing discard and rejection rates. We review the methods to improve selection, characterization of risks, and surgical techniques. Although the ECD kidneys have a higher risk of impaired donor and recipient outcome than the "standard criteria" transplants, it may be justified by the improved overall survival of these patients compared to those who remained on dialysis. It is, therefore, crucial that we perform meticulous selection, along with state of the art surgical techniques to maximize the use of this scarce resource. In this article, we review the pre-procurement and post-procurement processes implemented to preserve outcomes.
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Affiliation(s)
- Ziting Wang
- Department of Urology, National University Hospital, Singapore
| | - Pradeep Durai
- Department of Urology, National University Hospital, Singapore
| | - Ho Yee Tiong
- Department of Urology, National University Hospital, Singapore
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Al-Mamari SA, Jourdan J, Boukaidi S, Quintens H, Marsaud A, Carpentier X, Arnaud P, Mentine N, Durand M, Amiel J, Chevallier D. [Ipsilateral dual kidney transplantation: a monocentric experience about 15 cases and literature review]. Prog Urol 2014; 24:87-93. [PMID: 24485077 DOI: 10.1016/j.purol.2013.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 08/01/2013] [Accepted: 09/09/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Our study aimed to support the viability of the concept of Ipsilateral Dual Kidney Transplantation (DKT) by presenting our initial experience and proposing a review of the literature in this subject. METHODS Fifteen ipsilateral DKT were performed at Nice University Hospital between August 2010 and March 2012. We have described our skin incision preferences, the vascular anastomoses, and the uretero-vesical reimplantation. We have analyzed the operative duration, the cold ischemia time (CIT) of both transplants, the blood transfusion volume, the intraoperative and postoperative complications, the time to diuresis recovery, the hospital stay, and the kinetics of the creatinine clearance until the third postoperative month. We have compared our results with those of the literature. RESULTS The average CIT of the first transplant (T1) was 17.5 ± 3.3 hours, and that of the second (T2) was 18.4 ± 3.3 hours. The mean operating time was 234 ± 67 minutes. Patients received an average of 2 units of blood during surgery [0-4] and 1.8 units in the postoperative period [0-15]. The complications rate was 26.7% and included an intraoperative T2 artery thrombosis and 3 postoperative complications consistent with a hematoma, a T2 ureteric necrosis and a T2 venous thrombosis. Two transplants were lost (6.7%) and one death (6.7%) was reported on day 40. The average length of hospital stay was 20.9 ± 7.8 days. The mean creatinine clearance values were 12.6 mL/min at D2, 35.6 mL/min at D7, 44.9 mL/min on discharge, and 48.2 mL/min at D90. CONCLUSION Our results supported the viability of the dual kidney transplantation concept. Furthermore the ipsilateral approach shortened the procedure and limited the surgical trauma by preserving the contralateral iliac fossa, without compromising renal function recovery or increasing morbidity.
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Affiliation(s)
- S A Al-Mamari
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France.
| | - J Jourdan
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - S Boukaidi
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - H Quintens
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - A Marsaud
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - X Carpentier
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - P Arnaud
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - N Mentine
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - M Durand
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - J Amiel
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
| | - D Chevallier
- Service d'urologie, hôpital l'Archet 2, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, BP 06202, 23079 Nice cedex 3, France
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