Evolution of Laparoscopic Donor Nephrectomy Technique and Outcomes: A Single-center Experience With More Than 1300 Cases

A retrospective analysis of complications of laparoscopic left donor nephrectomy using the Kocak's modification of Clavien-Dindo system

“…Various reports estimate the surgical complication rate of LDN to be between 6% and 29%. [ 1 2 3 4 5 6 7 8 9 10 ]…”

“…However, Treat et al . [ 9 ] reported no significant difference for Clavien complication rates between the early learning period (first 150 cases) and the rest of the series ( n = 1275).…”

“…The reported complication rates of LDN range from 6% to 29%, with <2% incidence rate of conversion to open. [ 1 2 3 4 5 6 7 8 9 10 ] All potential donors should be informed about the inherent risks associated with donor nephrectomy. However, this is hindered by lack of uniformity in recognizing and reporting complications related to the procedure.…”

Urologic Considerations and Complications in Kidney Transplant Recipients

“…27,28 Advantages over open nephrectomy include less postoperative pain and scarring, a shorter hospital stay (1 to 3 days), sooner return to full activity (3 to 4 weeks), and magnified intraoperative visualization of the renal vascular anatomy. 27,28 Disadvantages to this approach include impaired early graft function secondary to intraoperative pneumoperitoneum decreasing blood flow to the kidney, the steep technical learning curve of laparoscopy, the expense of specialized instrumentation, and a small increase in complication rate. 27,28 In a normal, healthy donor with no extenuating anatomic or urologic anomalies, the left kidney is usually used, however, numerous series have demonstrated safety of using the right kidney.…”

“…27,28 Disadvantages to this approach include impaired early graft function secondary to intraoperative pneumoperitoneum decreasing blood flow to the kidney, the steep technical learning curve of laparoscopy, the expense of specialized instrumentation, and a small increase in complication rate. 27,28 In a normal, healthy donor with no extenuating anatomic or urologic anomalies, the left kidney is usually used, however, numerous series have demonstrated safety of using the right kidney. 29,30 Historically, patients with a history of nephrolithiasis were excluded from being donors, but with higher resolution imaging and the increased incidence of solitary, asymptomatic stones, recent recommendations have relaxed, allowing a stone former to be a potential donor.…”