Does Laterality Influence Outcomes in Paired Expanded Criteria Deceased Donor Kidney Transplantation: It All Depends on which Side You’re on!

Introduction: The study purpose was to determine if kidney laterality influences outcomes in expanded criteria donor (ECD) kidney transplants (KTs). Methods: A retrospective, case-control comparison of left versus right mate ECD kidneys transplanted at our center was performed. All patients received similar management protocols. Results: Over a 16-year period, left and right kidney pairs from 118 ECDs were transplanted as single allografts into 236 patients.Mean donor and recipient ages were both 61 years. 209 kidneys (88.6%) were pumped and mean cold ischemia time was 25 hours.Demographic characteristics were similar in both groups. Initial length of stay (mean 6.4 days), readmissions (53%), delayed graft function (24%), primary nonfunction (2.5%), and acute rejection (mean 14%) rates were similar between groups. With a mean follow-up of 80 months, patient (54% vs 59%) and kidney graft survival rates (both 41.5%) were comparable in recipients of left vs right kidneys, respectively. There were no significant differences in mean eGFR (based on MDRD) levels at 24 months (left 41 vs right 43 ml/min/1.73m2) in recipients with functioning kidneys. Conclusion: Based on the above findings, it is apparent that kidney laterality does not have a major impact on medium-term outcomes in recipients of ECD kidneys.