Living-donor kidney transplantation: comparison of sequential and simultaneous surgical organizations

Prudhomme, Thomas; Benoit, T.; Mittal, Shruti; Roumiguié, M.; Mesnard, B.; Broudeur, L.; Kervella, Delphine; Sallusto, Fédérico; Doumerc, N.; Binhazzaa, M.; Iborra, François; Soulié, M.; Blancho, Gilles; Kamar, Nassim; Thuret, Rodolphe; Karam, Georges; Gamé, X.; Branchereau, J.

doi:10.1007/s11255-019-02366-0

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Overall PNF (0.3%) and DGF (2.2%) rates observed in the present study are similar to the best results described in the literature 35 and reflect the short extraction time achieved with HALDN. Consistently maintaining cold ischemia time (CIT) below three hours has also undoubtedly played a role 35-37 but we do believe that other non‐measurable factors might have been beneficial. Specifically, during both TP‐HALDN and RP‐HALDN we have always allowed adequate time for the kidney to “rest” before stapling, ensuring optimal mean arterial pressure being established.…”

Section: Discussionmentioning

confidence: 99%

“…Consistently maintaining cold ischemia time (CIT) below three hours has also undoubtedly played a role [35][36][37] This practice is shared by many transplant centers and reduces the inevitable stress on the mentored surgeon while maintaining the highest quality of the service without the effects of multiple learning curves. 30,38 Reported incidence of DGF after LDRT varies from 4% to 10%, depending on the series.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes and surgical complications following living‐donor renal transplantation using kidneys retrieved with trans‐peritoneal or retro‐peritoneal hand‐assisted laparoscopic nephrectomy

Favi

Iesari

Catarsini

et al. 2020

Clinical Transplantation

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The best minimally invasive procedure for living-donor kidney retrieval remains debated. Our objective was to assess trans-peritoneal (TP) and retro-peritoneal (RP) hand-assisted laparoscopic donor nephrectomy (HALDN). In this single-center retrospective study, we analyzed results from 317 living-donor renal transplants (RT) performed between 2008 and 2016. Donor and recipient outcomes were compared between TP-HALDN (n = 235) and RP-HALDN (n = 82). Conversion to open nephrectomy (0.4% vs 0%; P = 1.000), intra-operative complications (1.7% vs 1.2%; P = 1.000), and 1-year overall post-operative complications (11.9% vs 17.1%; P = .258) rates were similar in TP-HALDN and RP-HALDN. Overall surgical site infections were higher in RP-HALDN (6.1% vs 1.7%; P = .053), whereas incisional hernias were only recorded following TP-HALDN (3.4% vs 0%; P = .118). The duration of the procedure was 11-minute shorter for TP-HALDN than RP-HALDN (P < .001) but extraction time was equivalent (2, IQR 1.5-2.5 minutes; P = 1.000). RT following TP-HALDN and RP-HALDN showed comparable one-year death-censored allograft survival (97% vs 98.8%; P = .685), primary non-function (0.4% vs 0%; P = .290), delayed graft function (1.3% vs 4.9%; P = .077), and urological complications (2.6% vs 4.9%; P = .290) rates. In our series, donor and recipient outcomes were not substantially affected by the approach used for donor nephrectomy. TP-HALDN and RP-HALDN were both safe and effective. K E Y W O R D S complications, hand-assisted laparoscopic nephrectomy, kidney transplantation, minimally invasive surgery, organ donation, outcomes, surgical training, ureteric leakage, ureteric stenosis, warm ischemia time How to cite this article: Favi E, Iesari S, Catarsini N, et al. Outcomes and surgical complications following living-donor renal transplantation using kidneys retrieved with transperitoneal or retro-peritoneal hand-assisted laparoscopic nephrectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes and surgical complications following living‐donor renal transplantation using kidneys retrieved with trans‐peritoneal or retro‐peritoneal hand‐assisted laparoscopic nephrectomy

Favi

Iesari

Catarsini

et al. 2020

Clinical Transplantation

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“…showed CIT and DGF were significantly higher in the sequential group than the simultaneous group, and CIT was a significant predictor of DGF. 18 Several studies showed varied results about ischemic time (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Correlation of total ischemic time to creatinine serum level and resistive index value in kidney transplant

Novianti

Duarsa

Aditya

et al. 2020

nsmc

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Background: The transient period when the kidney donor was extracted until being anastomosed (total ischemic time) will aggravate many putative molecular ischemic-reperfusion injury mechanisms. Several studies have reported the risk of delayed graft function development, which can be reflected by creatinine serum (Cr) level and resistive index (RI) value. This study aims to determine the correlation of total ischemic time to Cr levels reduction in one-month post-transplantation and RI value. Methods: This was a cross-sectional retrospective study involving subjects who underwent kidney transplantation in Sanglah General Hospital. In this study, the primary parameters were total ischemic time, Cr level, and RI value. The total ischemic time is calculated using a stopwatch intraoperatively. Cr level was obtained from blood examination, and RI value was obtained from the ultrasonography test. Data analysis was analyzed statistically using SPSS 24.0, and p < 0.05 was considered significant. Results: About 17 kidney transplant subjects were included in this study. The mean total ischemic time was 105 minutes and 43 seconds. There was an insignificant negative correlation between Cr level reduction and total ischemia time (r = -0.36; p = 0.89). An analysis of the correlation of total ischemic time and RI value, there was a linear correlation, but statistically insignificant (r = 0.11; p = 0.66). Conclusion: Total ischemic time has a negative correlation with post-transplant creatinine serum level and a positive correlation with the post-transplant resistive index value, but these results are not statistically significant.

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“…13 Other factors have been related to the prognosis of the kidney graft, such as cold and warm ischemia times. [14][15][16] The objective of this study was to explore the correlation between PrvO2 -taken directly from the renal vein after declamping the renal artery-and SCr, UV, and GFR five days after KT. The secondary objective was to assess whether PrvO2 is associated with a SGF in post-transplant patients.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Role of renal venous oxygen pressure for renal function monitoring after related living-donor kidney transplantation: cohort study

Escarramán-Martínez,

Fernández-Bravo,

Kammar-García

et al. 2023

Preprint

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IntroductionMonitoring of renal function after kidney transplantation (KT) is performed by measuring serum creatinine (SCr), urine volumes (UV), and glomerular filtration rate (GFR). Other methods based on oxygen metabolism such as the renal venous oxygen pressure (PrvO2) may be useful. We aimed to explore the correlation between PrvO2and SCr, UV, and GFR five days after KT (SCr5, UV5, and GFR5, respectively).MethodsWe conducted a prospective cohort study in adult patients scheduled for living-donor KT. A venous blood sample was taken from the renal vein after declamping the renal artery and blood gas determinations were made. Correlation analyses between PrvO2and SCr5, UV5, and GFR5, were done by calculating the Spearman correlation coefficient together with generalized linear models (GLM). A Spearman correlation analysis was performed between the percentage decrease in SCr (%ΔSCr) and PrvO2. A GLM was also performed to determine the association of PrvO2with slow graft function (SGF).Results42 patients were included; 66.7% were men, and the median age was 31 years (IQR: 27-43.5). PrvO2was negatively correlated with SCr5 (ρ=-0.53, p=0.003), and positively correlated with GFR5 (ρ=0.49, p=0.001) and %ΔSCr (ρ=0.47, p=0.002). A higher PrvO2was associated with an increase in GFR in univariable (β=1.24, 95%CI: 0.56-1.93, p=0.001) and multivariable (β=1.24, 95%CI: 0.53-1.94, p=0.001) analyses. No association was found between PrvO2and SGF.ConclusionPrvO2could be used to monitor renal function in the first 5 days following related living-donor KT given its good correlation with SCr and GFR.

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Living-donor kidney transplantation: comparison of sequential and simultaneous surgical organizations

Cited by 5 publications

References 20 publications

Outcomes and surgical complications following living‐donor renal transplantation using kidneys retrieved with trans‐peritoneal or retro‐peritoneal hand‐assisted laparoscopic nephrectomy

Outcomes and surgical complications following living‐donor renal transplantation using kidneys retrieved with trans‐peritoneal or retro‐peritoneal hand‐assisted laparoscopic nephrectomy

Correlation of total ischemic time to creatinine serum level and resistive index value in kidney transplant

Role of renal venous oxygen pressure for renal function monitoring after related living-donor kidney transplantation: cohort study

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