Trends in utilization and perioperative outcomes in live donor nephrectomies: a multi-surgical discipline analysis

Omidele, Olamide; Davoudzadeh, Natan; Shah, Milan; Tomer, Nir; Palese, Michael

doi:10.1007/s00345-018-2559-1

World J Urol

2018

DOI: 10.1007/s00345-018-2559-1

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Trends in utilization and perioperative outcomes in live donor nephrectomies: a multi-surgical discipline analysis

Olamide Omidele

Natan Davoudzadeh

Milan Shah

et al.

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2021

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Cited by 3 publications

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“…However, our SRTR analysis indicated no significant difference in mean ranking of 1-year survival or DD wait-time between KT centers led by urologists and general surgeons. Omidele et al similarly showed no difference in post-living donor nephrectomy outcomes among urologists, general surgeons, and transplant surgeons 10. Although general surgeons perform most KT, these findings suggest urologists remain reliable candidates to fulfill leadership obligations.Lee and colleagues emphasize the importance of additional degree attainment as a qualification for department surgical chairs 11.…”

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confidence: 97%

Kidney transplant surgical director training: Urologists represent a functional alternative to general surgeons

Ortiz

Choubey

Pai

et al. 2021

Clinical Transplantation

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Introduction: Kidney transplant (KT) directors are general surgeons or urologists. All KT centers must meet established performance standards. However, it has not been established if general surgery and urology led programs have disparate outcomes. Methods: Transplant outcomes and donor-recipient characteristics by director training were investigated. Organ Procurement and Transplantation Network (OPTN) directory, program websites were analyzed for surgical director demographics. Scientific Registry of Transplant Recipients (SRTR) 1-year kidney survival and deceased donor (DD) wait-time rankings were evaluated. A retrospective analysis of 142 157 KT recipients from 2010 to 2019 was performed using the United Network for Organ Sharing (UNOS) database.Results: One hunderd and seventy three (90.6%) KT programs were led by general surgeons. There were no significant differences in gender, ethnicity, region, credentials, or fellowship completion. Recipients undergoing KT with urology led programs were older (P = .002) and had longer wait-times (P < .001). These centers used higher KDPI (.47 vs. .45, P < .001) and higher HLA mismatch (3.92 vs. 3.89, P = .02) kidneys. Urology led centers utilized living donors less frequently (32.1% vs. 35.8%, P < .001) and had longer CIT (15.44 vs. 12.21, P < .001). Both had similar SRTR ranking of 1-year survival and DD wait-time. Conclusion:Most directors were general surgeon. Patient outcomes did not differ by transplant director training. Urologists represent a viable option for KT leadership and recruitment should be encouraged.

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mentioning

confidence: 97%

Kidney transplant surgical director training: Urologists represent a functional alternative to general surgeons

Ortiz

Choubey

Pai

et al. 2021

Clinical Transplantation

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Impact of diverticular disease on prostate cancer risk among hypertensive men

Tomer

Chakravarty

Ratnani

et al. 2021

Prostate Cancer Prostatic Dis

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Robot-Assisted Laparoscopic Living Donor Nephrectomy: The University of Florence Technique

et al. 2021

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Objective: To provide a step-by-step overview of the University of Florence technique for robotic living donor nephrectomy (LDN), focusing on its technical nuances and perioperative outcomes.Methods: A dedicated robotic LDN program at our Institution was codified in 2012. Data from patients undergoing robotic LDN from 2012 to 2019 were prospectively collected. All robotic LDNs were performed by a highly experienced surgeon, using the da Vinci Si robotic platform in a three-arm configuration. In this report we provide a detailed overview of our surgical technique for robotic LDN. The main objective of the study was to evaluate the technical feasibility and safety of the technique, including perioperative surgical complications rate and mid-term functional outcomes.Results: Overall, 36 patients undergoing robotic LDNs were included in the study. Of these, 28 (78%) were left LDNs. Median (IQR) donor pre-operative eGFR was 88 (75.6–90) ml/min/1.73 m2. In all cases, robotic LDN was completed without need of conversion. The median (IQR) overall operative time was 230 (195–258) min, while the median console time was 133 (IQR 117-166) min. The median (IQR) warm ischemia time was 175 (140–255) s. No intraoperative adverse events or 90-d major surgical complications were recorded. At a median (IQR) follow-up of 24 months (IQR 11-46), median (IQR) eGFR patients undergoing in living donor nephrectomy was 57.4 (47.9; 63.9) ml/min/1.73 m2.Conclusions: In our experience, robotic LDN is technically feasible and safe. The use of robotic surgery for LDN may provide distinct advantages for surgeons while ensuring optimal donors' perioperative and functional outcomes.

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Trends in utilization and perioperative outcomes in live donor nephrectomies: a multi-surgical discipline analysis

Cited by 3 publications

References 15 publications

Kidney transplant surgical director training: Urologists represent a functional alternative to general surgeons

Kidney transplant surgical director training: Urologists represent a functional alternative to general surgeons

Impact of diverticular disease on prostate cancer risk among hypertensive men

Robot-Assisted Laparoscopic Living Donor Nephrectomy: The University of Florence Technique

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