[Double kidney transplantation--a method to increase the donor pool].

The patients number on the transplant waiting lists are continuously increasing. The number of donors and transplantations can not reach this acceleration. To increase the number of organs we can use living donor organs or carefully selected extended criteria organs. To achieve appropriate function with marginal donor kidneys we need to transplant both kidneys into the same recipient. At the Transplant Division of University of Texas during a two years period we performed 5 double kidney transplantations with organs refused by the local transplant services. We placed both kidneys to the same side, retroperitoneally. The recipients mean age was 44.4 years and two of them belonged to the immunological risk ethnic group. After the transplantation all kidneys showed immediate function. During the patients mean hospital stay (6.25 days) the serum creatinine level decreased from 1000 micromol/l to 350 micromol/l. The Glomerular Filtration Rate (GFR) increased from 7 ml/min to 41 ml/min. Two patients suffered acute rejection which influenced their kidney function. During our two year follow up all patients avoided haemodyalsis. Double kidney transplantation is an acceptable solution for expanding the donor pool. After consistent and cautious selection previously rejected kidneys can be used.