Ipsilateral dual kidney transplantation: A monocentric experience about 15 cases and literature review [Bi-transplantation rénale par abord ipsilatéral: Expérience d'un centre à propos de 15patients opérés consécutivement et revue de la littérature]

摘要

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.