Dual Kidney Transplant.

During the past decades, dual kidney transplant has enabled greater use of marginal kidneys and reduced waiting time. Since the first description of dual transplant in 1996, the techniques and outcomes have improved. No clear allocation criteria for donors and suitable candidates have been outlined; however, in general, an older for older approach is followed by many centers. Many centers are hampered by the lack of a clear allocation policy and the fact that decisions for dual kidney transplant are solely clinician based. Unilateral placement of both kidneys is the technique of choice in many centers. En block pediatric dual transplant and several vascular reconstruction methods for dual kidneys have been adopted by surgeons to enable single arterial and venous anastomosis and to reduce complications. Although there is a higher prevalence of vascular complications, mainly in the form of graft thrombosis, the overall complication rate with dual kidney transplant is comparable to single kidney transplant. Kidney survival and function are encouraging and close to results with standard criteria single kidney transplant. Although the technique is well established in many centers, standardized guidelines are lacking. Here, we review the current experience with dual kidney transplant.