Correlation of Surgical Times with Laparoscopic Live Donor Kidney Transplant Outcomes

Abstract

Most studies revealed that ischemic time has substantial role in occurrence of delayed graft function (DGF) after deceased donor kidney transplantation. However, less is known about the potential impact of surgical times on early outcomes following live donor kidney transplantation. A retrospective cohort of 189 consecutive laparoscopic live donor kidney transplant (LDKT) recipients from January 2006 to August 2012 was analyzed to reveal the impact of pneumoperitoneum time (PT) and anastomosis time (AT) on donor and recipient length of hospital stay and early graft function (EGF). DGF was observed in 13 (6.8%) patients while slow graft function (SGF) was seen in 27 (14%) of the recipients. The median AT was 28 minutes (interquartile range 23, 35 minutes). AT was associated with DGF (Odds Ratio [OR] 1.044, per minute, 95% CI 1.007, 1.082, p = 0.018). Median recipient length of hospital stay was 8 (interquartile range 7, 11) days. Every 13.5 minutes of longer AT was associated with 1 extra day in hospital. The median PT was 180 minutes (interquartile range 144, 234 minutes). PT was associated with both DGF (OR 1.013 per minute, 95% CI 1.005, 1.021, p = 0.001) and SGF (OR 1.009 per minute, 95% CI 1.002, 1.016, p = 0.016). Every extra hour of PT was associated with 0.42 more days in hospital for the donor. Surgical times may be underestimated variables in dictating use of hospital resources. The effect of surgical times on long term hard outcomes entails further study.

Laparoscopic donor nephrectomy: technique and outcome, a single-center experience

“…Author details 1 Department of Urology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt. 2 Department of Anaesthiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.…”

“…Compared to dialysis, kidney transplantation is the best treatment option for patients with end-stage renal disease (ESRD), with significantly better survival rates [1]. Advancement in surgical techniques, improvements in postoperative care, specialized immunosuppressive treatment protocols, and increased rate of live kidney donations have certainly improved kidney transplant outcomes [2]. Additionally, live kidney donation offers numerous significant advantages, including shorter waiting time for transplantation, higher quality renal grafts, elective surgical setting, and an opportunity for a preemptive transplant [3,4].…”

Is Laparoscopic Technique Suitable for Initial Experience in Live Donor Nephrectomy? Results of The First 51 Cases

“…Renal transplantation (RT) is considered the best treatment option in last stage kidney failure and promises better survival rates than dialysis [1]. This better survival is due to improvements in surgical technique, increased quality in postoperative care and the introduction of individualized immunosuppressive treatment protocols and had improved transplant results [2]. Live donor nephrectomy (LDN), wherefore it is a surgical technique related to the main vascular structures, has the possibility of postoperative complications, and is a considerable surgical procedure because the people to whom the procedure is applied are healthy individuals.…”