Purpose: Dual kidney transplantation (DKT) enables broader utilization of kidneys from expanded criteria donors (ECDs), particularly elderly donors. Building upon our prior results, we now update outcomes after extending our DKT practice.
Methods: Between 2014 and 2024, we performed DKT in 25 patients utilizing kidneys from deceased donors aged over 70 years who had at least one high-risk factor: serum creatinine (sCr) level over 3.0 mg/dL or estimated glomerular filtration rate (eGFR) under 30 mL/min. We retrospectively compared outcomes among 25 DKT recipients with a cohort of 220 recipients of kidneys from standard criteria donors (SCDs) and 140 recipients from ECDs during the same period.
Results: DKT donors continued to demonstrate advanced age, higher rates of diabetes, and elevated sCr levels compared to SCD and ECD donors (p<0.01, respectively). DKT recipients similarly were older and had higher diabetes prevalence compared to recipients of single kidneys from ECDs and SCDs (p<0.01, both). Post-transplant outcomes showed DKT recipients achieved significantly lower nadir sCr levels and shorter times to achieve nadir sCr compared to single ECD recipients (p<0.01, respectively). Overall graft survival and patient survival rates in the DKT group remained comparable to those of single KT recipients from both SCD and ECD groups.
Conclusion: Updated analysis further supports DKT as an effective approach for utilizing kidneys from older, high-risk donors. Continued comparable graft survival outcomes reinforce the suitability of DKT to safely expand the donor pool, offering beneficial transplant options to a broader patient population.