Open Donor Nephrectomy is a Safe Approach for Starting Kidney Transplantation

Abstract

Aim: Living kidney donation is important due to the shortage of organ donors in Turkey. Classic retroperitoneal open donor nephrectomy is more beneficial as it can prevent intraperitoneal organ injuries and postoperative adhesion formation. Here we have presented our initial experience about donors who were undergone open donor nephrectomy. Material and Methods:We retrospectively analyzed 14 donors who were undergone open nephrectomy between November 2010 and June 2011. We reviewed demographic data, intraoperative and postoperative complications, hospital stay, and serum creatinine levels (discharge time, postoperative maximum level and currently) for these donors. Results: Fourteen donors were operated during this period. The male to female ratio was 8:6 among donors. Mean age was 43.57 (range; 27-68) years. Mean body mass index was 27.71 (range; 21.3-36.1). Five right and nine left kidneys were harvested. There was no intraperitoneal organ injury. All kidney grafts started to function immediately. There was no vascular thrombosis in the transplanted kidneys. There was one major hemorrhagic complication requiring reoperation (7.1%). There were three minor wounds complications (21.4%). None of the donors had incisional hernia. Mean postoperative hospitalization time was 5.85 (range; 4-18) days. Mean flow up period was 125 days (range; 18-210 days). Mean serum creatinine level of discharge time, postoperative maximum level, and currently were; 1.04 mg/dL (range; 0.6-1.7); 1.26 mg/dL (range; 0.8-1.9); 1.08 mg/dL (range; 0.78-1.41) respectively. Ortalama hastanede kalış süresi 5.85 gün (4-18gün), ortalama takip süresi 125gün (18-210 gün) idi. Ortalama serum kreatinin, taburculuk zamanında, postoperative en yüksek olduğu seviye ve şimdiki değerleri sırasıyla; 1.04 mg/dL (0.6-1.7 mg/dL); 1.26 mg/dL (0.8-1.9 mg/dL); 1.08 mg/dL (0.78-1.41 mg/dL) idi. Sonuç: Açık donör nefrektomi yaptığımız başlangıç serimizde major komplikasyon ile karşılaşmadık. Bu nedenle böbrek nakline yeni başlayan merkezler için başlangıçta açık donör nefrektominin güvenli bir yöntem olduğu kanaatindeyiz.