Dual Kidney Transplantation: A Review of Past and Prospect for Future

Table 3

Surgical complication of DKT versus SKT.

Author	Journal/year	DKT		SKT	Significance
		Surgical technique/number/immunosuppression	Complication	Complications	value
Frutos et al. [21]	Nefrologia/2012	20 bilateral Kidney placement through 2 independent incisions in each of the recipient’s iliac fossae/induction with basiliximab + prednisolone, tacrolimus & MMF	Hemorrhage 8 (40%)	Hemorrhage 10 (25%)	NSN
			Lymphocele 3 (15%)	Lymphocele 2 (5%)	SNS
			Resurgery 1 (5%)	Resurgery 1 (2.5%)	NS
			Arterial thrombosis 2 (10%)	Arterial thrombosis 2 (5%)
Snanoudj et al. [24]	American Journal of Transplantation/2009	81 monolateral or bilateral placement with one or two classical iliac incisions/received IL-2 receptor antagonist or ATG. Cyclosporine or tacrolimus, prednisolone and MMF were used after induction	Eventration, parietal abscess 6 (7.4%),	Eventration, parietal abscess 8 (11.4%)	NS
			Ureteral stenosis 9 (11.1%),	Ureteral stenosis 12 (17.1%)	NSN
			Urinary fistula 9 (11.1%)	Urinary fistula 15 (21.4%)	SNS
			Graft artery stenosis 9 (11.1%),	Graft artery stenosis 3 (4.3%)	NSN
			Graft partial infarction 3 (3.7%),	Graft partial infarction 4 (5.7%)	SNS
			Artery thrombosis 5 (6.2%) &	Artery thrombosis 2 (2.9%)	NS
			Vein thrombosis 6 (7.4%)	Vein thrombosis 1 (1.4%)
			Hemorrhage 10 (12.3%)	Hemorrhage 9 (12.9%)
Remuzzi et al. [16]	Journal of American Society of Nephrology/1999	24 bilateral placement through double inguinal incision/Prednisolone, Cyclosporine & mycophenolate mofetil	Urinary tract fistula 4	Urinary tract fistula 1	—
			Sepsis from urinary Tract 2	Sepsis from urinary Tract 2	—
			Deep vein thrombosis 1	Deep vein thrombosis 1	—
			Hematoma 1	Hematoma 1	—
			Gastrointestinal Bleeding 1	Gastrointestinal Bleeding 0	—
			Bowel occlusion 0	Bowel occlusion 0	—
Ekser et al. [19]	American Journal of Transplantation/2010	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 dosage	Renal vein thrombosis 1 (1%)	Renal vein thrombosis 1 (1.4%)	NS
			Wound dehiscence 5 (5%)	Wound dehiscence 2 (2.7%)	NSN
			Lymphocele 3 (3%)	Lymphocele 2 (2.7%)	SNS
			Hematoma 1 (1%)	Hematoma 0 (0%)	NS
			Incisional hernia 1 (1%)	Incisional hernia 0 (0%)
			Stenosis of ureteroneocystoanastomoses 2 (2%)	Stenosis of ureteroneocystoanastomoses 2 (2.7%)	NS
Islam et al. [22]	Journal of Transplantation/2016	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	Urologic complications 4/29 (14%)	Urologic complications 10/487 (2%)	S
			All 4 having ureteral stricture	6 out of 10 have anastomotic strictures and 4 has urine leak

. IL-2 (interleukin-2), ATG (antithymocyte globulin), MMF (mycophenolate mofetil), and CNI (calcineurin inhibitors).