Unusual Complications Following Living Donor Nephrectomy

Akoh, Jacob A; Rana, Tahawar A.; Stacey, Sarah

doi:10.1002/dat.20274

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…Bleeding constitutes a major risk in living donor nephrectomies as is further observed in a study conducted by Akoh et al . [ 8 ] In this study, among 58 patients, 4 (7%) of the patients had bleeding requiring postoperative transfusion. Most of the patients underwent open nephrectomy 89% and only 11% laparoscopic.…”

Section: Discussionmentioning

confidence: 70%

An account of the anesthetist's vigilance and prevention of adversity during donor nephrectomy

et al. 2016

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Here, we present the case of a 42 year old female patient, ASA1 and donor for renal transplant surgery of her husband. The pre-anesthesia visit did not reveal any co-morbidity on history and the physical examination was also within normal limits. The patient was taken to the operating room and routine monitoring in the form of non-invasive blood pressure (NIBP), SpO2 probe and five lead electrocardiogram were applied. Anesthesia was induced with midazolam 1mg intravenous (i/v), fentanyl 100 μg i.v, propofol 100mg i/v and vecuronium bromide 5 mg. i/v. At the end of surgery, anesthesia was reversed and breathing attempts were observed. Suddenly the monitor displayed a drop in the ETCO2 to 5-6 mmHg. Immediately the ventilator circuit was checked which was found to be in place and on chest auscultation, bilateral equal air entry was heard. Sudden bradycardia with heart beat dropping to 32 beats per minute and a blood pressure reading of 90/50 mmHg was displayed on the monitor. Surgeons were informed about the possibility of an intra-abdominal bleed. On surgical exploration, the renal artery pedicle ligature was found to have slipped away resulting in torrential amount of bleeding. The bleeder having been identified was secured and a complete inspection of other possible bleeding sites was done. Post operatively, the patient was shifted to the intensive care unit with inotropic support. It was decided to keep the patient mechanically ventilated on volume control mode of ventilation. The patient remained stable on post-operative day 5, the patient was shifted to the ward.

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Section: Discussionmentioning

confidence: 70%

An account of the anesthetist's vigilance and prevention of adversity during donor nephrectomy

et al. 2016

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“…Of note, in the study by Gjerston et al, While minor and self-resolving testicular pain may be just a nuisance, in some cases it may prove problematic. Akoh et al reported a case of a donor who had unrelenting testicular pain following right nephrectomy and eventually required an orchidectomy for symptomatic control (7). Felix et al also reported a donor who required orchiectomy in their analysis of post-operative complications from the Swiss Organ Living Donor Health Registry (8).…”

Section: Discussionmentioning

confidence: 99%

Incidence and correlates of testicular pain after kidney donation

Gandhi¹,

Murad²,

Hebert³

et al. 2022

Front. Urol.

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Some kidney donors experience testicular pain after donation. We studied the presence of testicular pain in male donors from The Renal and Lung Donor Evaluation (RELIVE) Study which investigated short- and long-term outcomes of 8922 kidney donors. Of the 2551 male donors with available testicular status data included in the analysis, 54 (2.12%) developed testicular pain 19 days (IQR 7, 40) after donation: 34 had testicular pain only, 6 had epididymitis, and 14 had both. Donors developing pain were 4 years older and pain occurred more often in those undergoing laparoscopic nephrectomy; 3.6% vs. 1.1% for open nephrectomy. Non-Hispanic White ethnicity and undergoing laparoscopic nephrectomy were associated with increased risk of testicular pain; RR 5.56 (95% CI 1.35, 22.84), p=0.02, RR 3.11 (95% CI 1.71, 5.65), p<0.001, respectively. Laterality of nephrectomy, however, was not associated with increased risk of testicular pain. Testicular pain is not infrequent and contrary to previous reports, left nephrectomy was not associated with a higher incidence of testicular pain. Donors should be routinely asked about this potentially bothersome complication.

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Unusual Complications Following Living Donor Nephrectomy

Cited by 2 publications

References 13 publications

An account of the anesthetist's vigilance and prevention of adversity during donor nephrectomy

An account of the anesthetist's vigilance and prevention of adversity during donor nephrectomy

Incidence and correlates of testicular pain after kidney donation

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