医学
肾
肾移植
移植
肾单位
重症监护医学
外科
内科学
作者
Robert J. Stratta,David Harriman,Venkat Gurram,Komal Gurung,B Sharda
出处
期刊:Current Opinion in Organ Transplantation
[Ovid Technologies (Wolters Kluwer)]
日期:2021-12-03
卷期号:27 (1): 75-85
被引量:4
标识
DOI:10.1097/mot.0000000000000946
摘要
The purpose of this review is to chronicle the history of dual kidney transplantation (DKT) and identify opportunities to improve utilization of marginal deceased donor (MDD) kidneys through DKT.The practice of DKT from adult MDDs dates back to the mid-1990s, at which time the primary indication was projected insufficient nephron mass from older donors. Multiple subsequent studies of short- and long-term success have been reported focusing on three major aspects: Identifying appropriate selection criteria/scoring systems based on pre- and postdonation factors; refining technical aspects; and analyzing longer-term outcomes. The number of adult DKTs performed in the United States has declined in the past decade and only about 60 are performed annually. For adult deceased donor kidneys meeting double allocation criteria, >60% are ultimately not transplanted. MDDs with limited renal functional capacity represent a large proportion of potential kidneys doomed to either discard or nonrecovery.DKT may reduce organ discard and optimize the use of kidneys from MDDs. New and innovative technologies targeting ex vivo organ assessment, repair, and regeneration may have a major impact on the decision whether or not to use recovered kidneys for single or DKT.
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