Greater odds of allograft survival after dual kidney transplant than expanded criteria donor transplant
BOSTON — Although allograft survival was lower in dual kidney transplant when compared with standard criteria donor transplant, it was significantly higher in dual kidney transplant recipients than in expanded criteria donor recipients, according to research presented at the American Transplant Congress.
“In dual kidney transplantation, the kidneys are from marginal donors that would otherwise just be discarded,” Amarpali Brar, MD, of SUNY Downstate Medical Center, told Healio/Nephrology. “Rather than discarding them, the two kidneys can be put in a single recipient, meaning more use of dual kidney transplants can actually reduce the discard rate.”
To assess the trends and outcomes in dual kidney transplant recipients, researchers used data from the United Network for Organ Sharing, focusing on the years from 2008 to 2017 (921 dual kidney transplant recipients included). Transplant recipients were grouped into one of three categories: standard criteria donor, expanded criteria donor or dual kidney transplant.
While allograft survival was similar between dual kidney transplant recipients and expanded donor criteria recipients from 2013 to 2017, researchers found that, overall, allograft survival was significantly higher in dual kidney transplant recipients than in expanded donor criteria recipients.
Researchers also discovered the number of dual kidney transplants performed have decreased over time and that 37.7% of transplant centers performed these procedures. Of these, most were performed in two transplant centers.
Brar proposed that the reason such a small number of centers perform dual kidney transplants is because “putting in two kidneys is double the labor for the same amount of money.”
However, “Dual kidney transplant is something that can be expanded upon,” she said. “First, we need a standardization of criteria for the use of dual kidney transplant and there also needs to be adequate reimbursement for these procedures. Dual kidney transplant has the potential to help with the discard rate.” – by Melissa J. Webb
Brar A, et al. Abstract B149. Presented at: American Transplant Congress. June 1-5, 2019; Boston.
Disclosure: Brar reports no relevant financial disclosures.