Early and Late Graft Function after Laparoscopic Hand-Assisted Donor Nephrectomy for Living Kidney Transplantation: Comparison with Open Donor Nephrectomy

Hoda, M. Raschid; Hamza, Amir; Greco, Francesco; Wagner, Sigrid; Fischer, Kersten; Fornara, Paolo

doi:10.1159/000273468

Cited by 10 publications

(5 citation statements)

References 52 publications

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“…54,55 More recent publications show that overall complication rates of LDN range from 4 to 30%, 44,56 which is in line with the complication rates we found. One could argue that the included studies in our analysis are hard to compare because not all of them assessed the same type of complications.…”

Section: Discussionsupporting

confidence: 90%

Systematic review and meta-analysis of the relation between body mass index and short-term donor outcome of laparoscopic donor nephrectomy

Lafranca

Hagen

Dols

et al. 2013

Kidney International

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In this era of organ donor shortage, live kidney donation has been proven to increase the donor pool; however, it is extremely important to make careful decisions in the selection of possible live donors. A body mass index (BMI) above 35 is generally considered as a relative contraindication for donation. To determine whether this is justified, a systematic review and meta-analysis were carried out to compare perioperative outcome of live donor nephrectomy between donors with high and low BMI. A comprehensive literature search was performed in MEDLINE, Embase, and CENTRAL (the Cochrane Library). All aspects of the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement were followed. Of 14 studies reviewed, eight perioperative donor outcome measures were meta-analyzed, and, of these, five were not different between BMI categories. Three found significant differences in favor of low BMI (29.9 and less) donors with significant mean differences in operation duration (16.9 min (confidence interval (CI) 9.1-24.8)), mean difference in rise in serum creatinine (0.05 mg/dl (CI 0.01-0.09)), and risk ratio for conversion (1.69 (CI 1.12-2.56)). Thus, a high body mass index (BMI) alone is no contraindication for live kidney donation regarding short-term outcome.

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Section: Discussionsupporting

confidence: 90%

Systematic review and meta-analysis of the relation between body mass index and short-term donor outcome of laparoscopic donor nephrectomy

Lafranca

Hagen

Dols

et al. 2013

Kidney International

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“…The findings of improved early function and reduced resistive indices are similar to those shown in studies of expanded criteria and DCDD kidneys when HMP was compared to SCS. The average serum creatinine at 1 year in our SCS group (135 AE 48.7 lmol/l) and our HMP group (111 AE 29 lmol/l, P = 0.03 vs. SCS group) is in keeping with and seems slightly lower, respectively, compared to values reported in other studies of LDK [21][22][23]. In one study [21], comparing laparoscopic to open donor nephrectomy, the mean creatinine at 1 year in the laparoscopic group was 130 AE 46 lmol/l.…”

Section: Discussionsupporting

confidence: 87%

“…In one study , comparing laparoscopic to open donor nephrectomy, the mean creatinine at 1 year in the laparoscopic group was 130 ± 46 μmol/l. In another study , comparing different approaches to living donor nephrectomy, the one‐year creatinine was 132 ± 56 μmol/l.…”

Section: Discussionmentioning

confidence: 99%

Early experience with hypothermic machine perfusion of living donor kidneys - a retrospective study

et al. 2017

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Although hypothermic machine perfusion (HMP) has been shown to be beneficial to deceased donor kidneys, the effect of HMP on living donor kidneys (LDK) is unknown. LDK are subjected to minutes of normothermic ischemia at the time of recovery. Comparison of 16 LDK preserved by HMP with 16 LDK preserved by static cold storage (SCS). Outcomes of interest are resistive indices (RI), both while on HMP and postoperatively, and creatinine clearance (CrCl). Injury markers NGAL and LDH were seen in the perfusate of LDK in amounts similar to what is found for donation after neurological determination of death kidneys. Compared to SCS kidneys, CrCl was significantly higher in the HMP group from days 2 through 7 post-transplant [ie: day 7 (78.8 ± 5.4 vs. 54.0 ± 4.6 ml/min, P = 0.005)]. CrCl at 1 year was higher in the HMP group (81.2 ± 5.8 vs. 70.0 ± 5.3 ml/min, P = 0.03). Early post-transplant RI was significantly lower in the HMP group (0.61 ± 0.02 vs. 0.71 ± 0.02, P < 0.0001). Our data support the assertion that injury does occur during LDK procurement and suggest that some of this injury may be reversed with HMP, resulting in more favorable early RI and graft function compared to SCS kidneys.

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“…1,2 Living donor nephrectomy was first introduced 50 years ago. 3 Since then, numerous studies have shown superior outcomes over deceased donor nephrectomy with regards to long-term patient and graft survival. 4 A number of surgical techniques have been developed to minimize morbidity for donors, while maintaining optimal function of transplanted kidneys for recipients.…”

Section: Introductionmentioning

confidence: 99%

Back-to-back comparison of mini-open vs. laparoscopic technique for living kidney donation

Rampersad

Patel

Koulack

et al. 2016

CUAJ

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Introduction: Laparoscopic living donor nephrectomy is the standard of care at high-volume renal transplant centres, with benefits over the open approach well-documented in the literature. Herein, we present a retrospective analysis of our single-institution donor nephrectomy series comparing the mini-open donor nephrectomy (mini-ODN) to the laparoscopic donor nephrectomy (LDN) with regards to operative, donor, and recipient outcomes. Methods: From 2007-2011, there were 89 cases of mini-ODN, at which point our centre transitioned to LDN; 94 cases were performed from 2011-2014. In total, 366 patients were reviewed, including donor and recipient pairs. Donor and recipient demographics, intraoperative data, postoperative donor recovery, recipient graft outcomes, and financial cost were assessed comparing the surgical approaches. Results: We demonstrate a reduced estimated blood loss (347.83 vs. 90.3 cc), lower intraoperative complication rate (4 vs. 11) and shorter length of hospital stay (2.4 vs. 3.3 days) for patients in the LDN group. Operative time was significantly longer for the LDN group (108.4 vs. 165.9 minutes), although this did not translate to a longer warm ischemia time (mean 2.0 minutes for each group). The rate of delayed graft function and recipient 12-month creatinine were comparable for ODN and LND. Overall cost of LDN was $684 higher for an uncomplicated admission. Conclusions: Despite a longer surgical time and higher upfront cost, our study supports that LDN yields several advantages over the mini-ODN, with a lower estimated blood loss, fewer intraoperative complications, and shorter length of hospital stay, all while maintaining excellent renal allograft outcomes.

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Early and Late Graft Function after Laparoscopic Hand-Assisted Donor Nephrectomy for Living Kidney Transplantation: Comparison with Open Donor Nephrectomy

Cited by 10 publications

References 52 publications

Systematic review and meta-analysis of the relation between body mass index and short-term donor outcome of laparoscopic donor nephrectomy

Systematic review and meta-analysis of the relation between body mass index and short-term donor outcome of laparoscopic donor nephrectomy

Early experience with hypothermic machine perfusion of living donor kidneys - a retrospective study

Back-to-back comparison of mini-open vs. laparoscopic technique for living kidney donation

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