Early experience with dual kidney transplantation in adults using expandeddonor criteria

Dual transplant of marginal kidneys otherwise not considered for single tra nsplant may give access to an expanded pool of cadaveric organs without exp osing recipients to the drawbacks of a limited nephron mass supply. This pr ospective, case-control study compares adverse events and graft outcome in 24 recipients of two marginal kidneys from donors who were >60 yr old or wh o had diabetes, hypertension, or non-nephrotic proteinuria (cases), with th at of 48 age- and gender-matched control subjects who received single ideal grafts at the same center and were given the same immunosuppressive therap y. Marginal kidneys with no macroscopic abnormalities were selected for the double transplant on the basis of a predefined score of histologic damage. Six-month patient and kidney survival was 100% with both of the procedures . Incidence (20.8% versus 20.8%) and median (range) duration of posttranspl ant anuria (5 [2 to 12] versus 7 [2 to 13] days) were comparable in cases a nd control subjects, respectively, Time to normal serum creatinine and mean serum.