Comparison of laparoscopic and open donor nephrectomy: UK experience

Abstract

OBJECTIVETo compare our early experience of laparoscopic donor nephrectomy (LDN) with a contemporary cohort of conventional open donor nephrectomy (ODN). PATIENTS AND METHODSTransperitoneal left-sided LDN was offered to carefully selected potential live kidney donors on the basis of vascular anatomy. The first 20 donors who underwent LDN were compared with a control group of 20 patients who had ODN. Donors and recipients were compared for demographics, intraoperative variables, postoperative complications and allograft function. RESULTSThere was no peri-operative mortality in either group. No laparoscopic procedure required open conversion. The operating time was comparable (165 vs 153 min); LDN was associated with significantly less intraoperative blood loss (200 vs 350 mL; Mann-Whitney U , P = 0.01) and hospital stay (3 vs 5 days; P < 0.001). The graft warm ischaemic time was significantly longer for LDN (5 vs 2 min; P < 0.001) but this did not appear to affect either the delayed graft function rate (5% vs 10%, not significant) or serum creatinine level at discharge (125 vs 126 µ mol/L). CONCLUSIONSUK centres with experience of advanced laparoscopy and ODN can safely offer LDN to potential live donors.

Comparison between laparoscopic and subcostal mini-incision for live donor nephrectomy

“…However, none of this data has jeopardized primary graft function or has put at risk graft and patient survival. Rates of complications and graft survival were similar in both groups, similar to what has been reported by other groups, although a higher rate of complications was observed in the laparoscopic group, probably related to the learning curve of this approach (7)(8)(9)(10) . Laparoscopic operative time and disposable material used for this procedure enhance the overall transplantation costs.…”

Surgical complications of open nephrectomy in living related donors in Yemen: a prospective study

“…[14] The reported mortality rate of the live kidney donors is very low (0.02%) [3] and it was mainly reported in the early open and laparoscopic donor nephrectomies. [5] In recent series [15,16] and our series there is no mortality. Lack of a unifying grading system of complications was one of the obstacles for precise definition, recording and reporting about morbidity of live donor nephrectomies which was underestimated and underreported in some series.…”

Surgical Complications of Renal Transplantation

“…This, indeed, is standard procedure in many transplant centers, (Wilson CH, 2005;Hsu TH, 2003) showing no significant adverse effects on the function and graft survival in VDL nephrectomies without or with hand assistance which may lead to higher vascular extension. (Saidi R, 2009;Hoda MR, 2010;Hoda MR, 2011) However, there is need for close attention to the anatomy of the donor due to the possibility of having two or more arteries and veins, or early arterial bifurcation (Benedetti E, 1995;Mazzucchi E, 2005;Harper JD, 2010).…”