Current concepts in transplant surgery: laparoscopic living donor of the kidney

Paul, Andreas; Treckmann, Jürgen; Gallinat, Anja; Witzke, Oliver; Vester, Udo; Broelsch, Christoph E.

doi:10.1007/s00423-007-0192-3

Cited by 5 publications

(7 citation statements)

References 47 publications

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“…Exact effects, risks and limitations of learning curves in LDN are difficult to estimate. Descriptions vary, from 20% major complications during the first 50 cases and 6% during cases 200-250 to 30% major complications during the first 30 LDN cases with no complications during the following 50 cases [4,5,[21][22][23]. In our center, LDN is carried out by only one general and transplant surgeon, who has the expertise to perform laparoscopic kidney donation after sufficient training and experience in advanced laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Virtually all donors eligible for an open surgical procedure may also undergo the laparoscopic operation. Various earlier contraindications to LDN, such as right donor kidney, multiple vessels, anomalous vasculature and obesity have been overcome with increasing experience [16,22,24,25,27]. The contraindications to kidney donation are similar in both open and laparoscopic procedures and focus on maintaining acceptable long term renal function in the donor.…”

Section: Conversion Ratementioning

confidence: 99%

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The Evolution of Living Donor Nephrectomy Program at A Hellenic Transplant Center. Laparoscopic vs. Open Donor Nephrectomy: Single-Center Experience

Vernadakis

Marinaki

Darema

et al. 2021

JCM

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Since its introduction in 1995, laparoscopic nephrectomy has emerged as the preferred surgical approach for living donor nephrectomy. Given the ubiquity of the surgical procedure and the need for favorable outcomes, as it is an elective operation on otherwise healthy individuals, it is imperative to ensure appropriate preoperative risk stratification and anticipate intraoperative challenges. The aim of the present study was to compare peri-and postoperative outcomes of living kidney donors (LD), who had undergone laparoscopic nephrectomy (LDN), with a control group of those who had undergone open nephrectomy (ODN). Health-related quality of life (QoL) was also assessed using the validated SF-36 questionnaire. Data from 252 LD from a single transplant center from March 2015 to December 2020 were analyzed retrospectively. In total, 117 donors in the LDN and 135 in the ODN groups were assessed. Demographics, type of transplantation, BMI, duration of surgery, length of hospital stay, peri- and postoperative complications, renal function at discharge and QoL were recorded and compared between the two groups using Stata 13.0 software. There was no difference in baseline characteristics, nor in the prevalence of peri-and postoperative complications, with a total complication rate of 16% (mostly minor, Clavien–Dindo grade II) in both groups, while a different pattern of surgical complications was noticed between them. Duration of surgery was significantly longer in the ODN group (median 240 min vs. 160 min in LDN, p < 0.01), warm ischemia time was longer in the LDN group (median 6 min vs.2 min in ODN, p < 0.01) and length of hospital stay shorter in the LDN group (median 3 days vs. 7 days in ODN). Conversion rate from laparoscopic to open surgery was 2.5%. There was a drop in estimated glomerular filtration rate (eGFR) at discharge of 36 mL/min in the LDN and 32 mL/min in the ODN groups, respectively (p = 0.03). No death, readmission or reoperation were recorded. There was a significant difference in favor of LDN group for each one of the eight items of the questionnaire (SF1–SF8). As for the two summary scores, while the total physical component summary (PCS) score was comparable between the two groups (57.87 in the LDN group and 57.07 in the ODN group), the mental component summary (MCS) score was significantly higher (62.14 vs. 45.22, p < 0.001) in the LDN group. This study provides evidence that minimally invasive surgery can be performed safely, with very good short-term outcomes, providing several benefits for the living kidney donor, thereby contributing to expanding the living donor pool, which is essential, especially in countries with deceased-donor organ shortage.

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Section: Discussionmentioning

confidence: 99%

Section: Conversion Ratementioning

confidence: 99%

The Evolution of Living Donor Nephrectomy Program at A Hellenic Transplant Center. Laparoscopic vs. Open Donor Nephrectomy: Single-Center Experience

Vernadakis

Marinaki

Darema

et al. 2021

JCM

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“…Die Operationsdauer lag mit durchschnittlich 162 ± 27 min im Bereich der in der Literatur für eine konventionelle Spendernephrektomie angegebenen Zeiten zwischen 114 bis 180 min [10,[19][20][21][22][23][24][25]. Die laparoskopische und Hand-assistierte laparoskopische Spendernephrektomie dauert länger und liegt bei Operationszeiten zwischen 180 und 221 min [10,[19][20][21][22][23][24][25].…”

Section: Diskussionunclassified

“…Die laparoskopische und Hand-assistierte laparoskopische Spendernephrektomie dauert länger und liegt bei Operationszeiten zwischen 180 und 221 min [10,[19][20][21][22][23][24][25].…”

Section: Diskussionunclassified

Ist die konventionelle Spendernephrektomie zur Nierenlebendspende noch zeitgemäß?

Thiel¹,

Thiel²,

Schenk³

et al. 2011

Wien Klin Wochenschr

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“…Durch einen verkürzten Krankenhausaufenthalt, weniger Schmerzen und das bessere kosmetische Ergebnis gewinnt die laparoskopische Nephrektomie immer mehr an Popularität [1,23,24]. Die kürzlich publizierten Übersichtsarbeiten zu dieser Thematik zeigen aber hinsichtlich der Sicherheit der Operation einen Trend zugunsten der offenen Nephrektomie.…”

Section: > Langzeitstudien Zeigen Keine Erhöhten Risiken Nach Uni-nepunclassified

Lebendspende-Nierentransplantation

Mehrabi

Fonouni

Golriz

et al. 2010

Chirurg

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Due to the existing organ shortage the option of a kidney transplantation (KTx) in patients with end-stage renal disease is not always possible despite the offer of this therapy. So far the required number of KTx could not be adequately achieved by organ donations from deceased persons. To solve this problem living donation KTx programs have already become established in many transplantation centers. In published reports it has been shown that with the living donation program better results could be achieved in terms of graft function and patient survival compared to cadaver donation KTx. Therefore, living donation KTx allows an optimal alternative to expand the organ pool. The aim of our study is to present the long-term results of our living donation KTx program regarding graft function and patient survival. Finally, the risks of living donation KTx will be discussed based on the reported experiences of other centers.

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Current concepts in transplant surgery: laparoscopic living donor of the kidney

Abstract: According to our results and the results available in the literature, laparoscopic living donor nephrectomy is safe when performed with sufficient experience. Postoperative pain is less and recovery is significantly faster.

Cited by 5 publications

References 47 publications

The Evolution of Living Donor Nephrectomy Program at A Hellenic Transplant Center. Laparoscopic vs. Open Donor Nephrectomy: Single-Center Experience

The Evolution of Living Donor Nephrectomy Program at A Hellenic Transplant Center. Laparoscopic vs. Open Donor Nephrectomy: Single-Center Experience

Ist die konventionelle Spendernephrektomie zur Nierenlebendspende noch zeitgemäß?

Lebendspende-Nierentransplantation

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