[Analysis of outcomes in adult deceased donor dual kidney transplantation].

<b>Objective:</b> To investigate the efficacy of dual kidney transplantation (DKT) from adult donors. <b>Methods:</b> Clinical data of adult DKT donors and recipients in the Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2015 to June 2024 were retrospectively analyzed. The patients were followed up until September 2024. The clinical data of donor and recipient, donor kidney, surgical techniques, complications, and follow-up were collected. Transplant renal function and recipient/graft survival rates within 5 years were analyzed. <b>Results:</b> A total of 102 pairs of DKT donors and recipients were included. Among the donors, 83 were male and 19 were female, with age of (57.8±11.1) years and body mass index (BMI) of (23.1±3.2) kg/m². Among the recipients, 95 were male and 7 were female, with age of (42.0±11.0) years and BMI of (22.1±3.1) kg/m². The postoperative hospitalization and follow-up duration [<i>M</i> (<i>Q</i>₁, <i>Q</i>₃)] for recipients were [20.0 (15.0, 27.0)] days and [30.0 (12.5, 49.0)] months, respectively. China Class Ⅱ donation accounted for 64.7% (66/102) of donor categories. The pre-procurement serum creatinine (Scr) level of donors was [97.0 (66.5, 144.5)] μmol/L, and the hypothermic machine perfusion utilization rate was 52% (53/102). The warm ischemia time was (5.5±1.7) minutes, and the mean cold ischemia time was (8.7±3.8) hours. The Remuzzi scores for the left and right kidneys before transplantation were (4.8±1.3) and (5.1±1.4) scores, respectively. The glomerulosclerosis rates for the left and right kidneys were 34.0%±16.2% and 35.3%±16.7%, respectively. The primary nephropathy was unknown in 80.3% (82/102) of recipients, and IgA nephropathy was diagnosed in 8.8% (9/102) of the recipients. Bilateral kidneys were implanted ipsilaterally in 94.1% (96/102) of recipients, with operative time of (5.3±1.4) hours. Lymphocyte-depleting induction therapy was administered to 74.5% (76/102) of recipients. One recipient experienced primary graft non-function after surgery. The incidences of delayed graft function and rejection were 30.4% (31/102) and 9.8% (10/102), respectively. The overall incidence of surgical complications was 10.8% (11/102). The 1, 3, and 5-year recipient survival rates were 100.0%, 98.3%, and 98.3%, respectively. The 1, 3, and 6-month and 1, 3, and 5-year graft survival rates were 97.1%, 96.1%, 95.0%, and 94.0%, 89.3%, 85.6%, respectively. The recipient's kidney function remains stable for 5 years after transplantation. At 5 years, the recipient median Scr level and mean estimated glomerular filtration rate (eGFR) were 153.0 (120.0, 232.0) μmol/L and (42.1±17.1) ml^-1·min^-1·(1.73 m²)^-1, respectively. <b>Conclusion:</b> Adult donor DKT demonstrates favorable short-term and 5-year clinical efficacy.