9/Dual kidneys were transplanted intraperitoneally or through bilateral extraperitoneal incision/induction was either with ATG or OKT3 followed by cyclosporine, AZA and prednisolone/selection Criteria: donor older than 60 years and/or long history of hypertension or diabetes with cold ischemia time less than 30 hours. Further criteria included creatinine clearance levels between 80 and 40 mL/min and with kidneys that showed less than 40% glomerulosclerosis without severe interstitial fibrosis or arteriosclerosis on biopsy
24/Bilateral placement through double inguinal incision/Prednisolone, Cyclosporine & mycophenolate mofetil. No comment on induction/Selection Criteria: brain dead donors having 1 of the following• Age > 60 year• History of diabetes or hypertension• Clinical proteinuria (urinary protein excretion rate up to 3 g/24 h) plus renal histopathology score of 4–6
100% graft survival at 6 months and 93% at 3 years
50/Bilateral placement in right and left iliac fossa via midline extra peritoneal approach/Cyclosporine, steroids & MMF or AZA. Induction with OKT3 or IL-2 inhibitor/Selection Criteria: ECD refused by other centers due to hypertension, donor instability, donor age or pretransplantation biopsy result and creatinine clearance less than 90 ml/minute in donors with age greater than 60 years
21/Each kidney was implanted extraperitoneally in each iliac fossae/Prednisolone, cyclosporine or tacrolimus and MMF/selection criteria/age greater than 75 or 60–74 and pregraft biopsy showing greater than 15% glomerulosclerosis and lesser than 50% glomerulosclerosis
625 received DKT/no comment on surgical technique or immunosuppression/selection criteria: any 2 of the following criteria present: age greater than 60 years, creatinine clearance greater than 65 mL/min, rising serum creatinine greater than 2.5 mg/dL at retrieval, chronic hypertension or type 2 diabetes mellitus, and glomerulosclerosis on biopsy between 15% and 50%
23 non heart beating DKT/ipsilateral dual transplant, the 2 kidneys from a single donor are implanted into the right iliac fossa with anastomoses to the common (right kidney) and external iliac (left kidney) arterial circulation/no comment on immunosuppression medications/selection criteria: machine perfusion pressure flow index 0.4 mL/min per 100 g/mm Hg and glutathione transferase was greater than 100 IU/L/100 grams renal mass
Glomerular filtration rate at 3 and 6 months was 46.2 & 45.5 ml/minute
81/Allografts were placed either monolaterally or bilaterally, with one or two classical iliac incisions, respectively/received IL-2 receptor antagonist or ATG. Cyclosporine or tacrolimus, prednisolone and MMF were used after induction/selection criteria: ECD donors aged > 65 years and estimated glomerular filtration rate was between 30 and 60 mL/min
Glomerular filtration rate at 12 months 47.8 mL/min
100/Unilateral extraperitoneal placement via Gibson incision/Induction therapy consisted of antithymocyte globulin (ATG) or Basiliximab. Maintenance immunosuppressive sirolimus or everolimus either without a calcineurin inhibitor (CNI) or with a reduced CNI/selection criteria: high risk marginal donor (donor with age ≥ 70 0r 60–69 with either one of the Serum creatinine > 1.5 mg/dl, calculated creatinine clearance ≤ 60 ml/minute, history of hypertension and or diabetes, proteinuria > than 1 gram, cause of death cerebrovascular accident) plus biopsy score 4–6
Glomerular filtration rate at 1 year and 2 years was 115 ± 32 and 128 ± 45 ml/minute
1308/No comment on surgical technique or immunosuppressive medications used/selection criteria: DKT was done in KDRI score 1.4, 1.41–1.8, 1.8–2.2 and greater than 2. DKT showed superior graft survival when KDRI was greater than 2
Five-year graft survival rates of SKT and DKT by KDRI were as follows: 1.4 (74%, 72%), 1.41–1.8 (63%, 64%), 1.81–2.2 (55%, 59%) and >2.2 (48%, 54%).
20/Dual kidney transplantation was performed through 2 independent incisions in each of the recipient’s iliac fossae/Immunosuppressive medications included induction with basiliximab. Maintenance immunosuppression included prednisolone, tacrolimus & MMF/selection criteria: DKT was done through biopsy scoring plus clinical parameter including Donor’s age, medical history, kidney size and creatinine clearance were also considered
Creatinine clearance at 6 months and 1 year was 59.0 ± 18 ml/minute 55.0 ± 18.5 ml/minute
29/Extraperitoneal placement in right iliac fossa through curvilinear incision/high risk recipients received ATG and the rest either daclizumab or basiliximab. Maintenance immunosuppression consisted of tacrolimus, MMF, and prednisone/selection criteria: Expanded criteria donors (ECD), defined as deceased donors () greater than 60 years old or () greater than 50 years old and with at least 2 of the following criteria: (a) a history of hypertension, (b) terminal serum creatinine greater than 1.5 mg/dL, or (c)death due to a cerebrovascular accident OR Kidneys from standard criteria donors (SCD) that were deemed functionally compromised due to high serum creatinine, poor pump characteristics, or unfavorable histology on biopsy
Median e GFR (IQR) in mL/min/1.73 m2 at 12 months was 56.0 (42.6–67.9) & at 24 months 53.4 (46.4–66.4) ml/minute
. MMF (mycophenolate mofetil), AZA (azathioprine), IL-2 (interleukin-2), ECD (extended Criteria Donor), e GFR (estimated glomerulofilteration rate), ATG (antithymocyte globulin), and SCD (standard criteria donor), OKT3 (muromonab-CD3).
