Transplanting two kidneys from older deceased donors to reduce discards

Here's a venerable but newly fashionable idea in transplantation, particularly for deceased donors whose (individual) kidneys have already been rejected when offered.  Transplant both kidneys into the same recipient, to reduce the risk.

Here's a paper from January:

Lee, K.W., Park, J.B., Cha, S.R. et al. Dual kidney transplantation offers a safe and effective way to use kidneys from deceased donors older than 70 years. BMC Nephrol 21, 3 (2020). https://doi.org/10.1186/s12882-019-1664-8

And here's a very recent news article talking about a different, larger study:

July 30, 2020

Using older donor kidneys for dual transplant may present safe way to reduce discard rate

By Melissa J. Webb

"Using data from the United Kingdom Transplant Registry, they identified 7,841 kidneys procured from deceased donors aged 60 years or older, finding that 17% of these were discarded.

Considering the remaining kidneys used for transplant (356 for dual; 5,032 for single), the researchers determined that both donors and recipients of dual transplants were older (median, 73 years vs. 66 years and 64 years vs. 61 years, respectively). Donors of kidneys used in dual transplantation also had higher United States Kidney Donor Risk Indices (2.48 vs 1.98 for those used in single transplants).

After adjusting for confounders, the researchers observed similar 5-year graft survival between dual and single transplants (HR = 0.81), as well as a higher median eGFR at 12 months for recipients of dual transplants (40 mL/min/1.73m2 vs. 36 mL/min/1.73m2)."