Dual kidney transplantation: case report

Scientific paper - Case study

• Title (croatian): Dovstruka transplantacija bubrega
• Author: Željko Vidas
• Author: Branislav Kocman
• Author: Mladen Knotek
• Author: Dinko Škegro
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Chronic shortage of kidney transplants worldwide has led to the use of organs from so called marginal or borderline donors, now termed "expanded-criteria donors". There has been an emerging practice of dual kidney transplantation (DKT) to compensate for sub optimal nephron mass of such kidneys. We performed DKT in "Merkur" University Hospital in August 2005. The donor was a 72-year old female with a history of long-term hypertension, aneurysm of the posterior cerebral artery, cerebrovascular insult (CVI), and with normal creatinine values and kidney function at the time of explantation. Initial biopsy of donor kidneys revealed acute tubular damage, with connective changes in 22% and 11% of glomeruli in the left and the right kidney, respectively. The recipient was a 60-year old male diagnosed with the IgA nephropathy on the last biopsy in 1999, and on dialysis since November 2003. Postoperative course was uneventful without any surgical complications. A triple immunosuppressive protocol was used. On follow-up ultrasonography 4 years posttransplantation both kidneys appeared of normal size and parenchymal pattern and with no signs of dilatation of the canal system, and color Doppler examination demonstrated normal flow in both kidneys. In conclusion, the use of DKT ie. donors by the expanded-criteria will continue to increase, and further studies of the results will, with no doubt, support this method.

Abstract (croatian)

Kronični nedostatak bubrega za transplantaciju u svijetu doveo je do uzimanja organa od takozvanih graničnih ili marginalnih donora što je kasnije dobilo naziv »donor prema proširenim kriterijima«. U Kliničkoj bolnici Merkur, u kolovozu 2005. Godine napravljena je dvostruka transplantacija bubrega. Donor je bila 72-godišnja bolesnica s anamnezom dugogodišnje hipertenzije, aneurizme stražnje cerebralne arterije, cerebralnim vaskularnim inzultom (CVI) te urednim nalazima kreatinina i funkcijom bubrega kod eksplantacije. Učinjena je nulta biopsija donorskih bubrega gdje je na lijevom bubregu nalaz odgovarao akutnom tubularnom oštećenju uz 22% vezivno promijenjenih glomerula. Na desnom bubregu nalaz je odgovarao akutnom tubularnom oštećenju uz 11% vezivno promijenjenih glomerula. Primatelj je bio muška osoba stara 60 godina kod koje je posljednja biopsija učinjena 1999. godine pokazala IgA nefropatiju te je bio na programu hemodijalize od studenog 2003. godine. Postoperacijski tijek prošao je uredno bez ijedne kirurške komplikacije. Korišten je protokol trostruke imunosupresije. Na kontrolnom pregledu 4 godine nakon transplantacije, ultrazvučnim pregledom utvrdi se normalna veličina oba bubrega s održanim parenhimom bez znakova dilatacije kanalnog sustava te uredan dopler protok kroz oba bubrega. Možemo zaključiti da će broj dvostrukih transplantacija bubrega, odnosno korištenje donora prema proširenim kriterijima biti sve veći, a daljnje praćenje rezultata zasigurno opravdati ovu metodu.

• Keywords (english): Aged; Cadaver; Female; Follow-Up Studies; Glomerulonephritis, IGA / surgery; Humans; Immunosuppressive Agents / therapeutic use; Kidney Transplantation / methods; Male; Middle Aged; Tissue Donors; Treatment Outcome
• Language: english
• Publication type: Scientific paper - Case study
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Collegium Antropologicum
• Numbering: vol. 34, no. 2, pp. 697-700
• p-ISSN: 0350-6134
• URN:NBN: urn:nbn:hr:105:227828
• Publication: 2010-06
• Document URL: https://hrcak.srce.hr/56536
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 11:47:14