2258 BASILIXIMAB INDUCTION THERAPY COMBINED WITH A LOWER TARGET TROUGH LEVEL OF TACROLIMUS AND LOW DOSE OF MYCOPHENOLATE MOFETIL DECREASED INTERSTITIAL FIBROSIS AT 1-YEAR POSTTRANSPLANTATION AND IMPROVED THE 5-YEAR GRAFT SURVIVAL

Abstract

INTRODUCTION AND OBJECTIVES: The purpose of this study was to compare in a prospective randomized fashion the clinical outcomes following Standard Laparoscopic and LESS donor nephrectomy. METHODS: Fifty voluntary renal donors were randomized to Standard Laparoscopic (Group A) and LESS (Group B) donor nephrectomy (January 2009 till February 2010). The primary end point of the study was patients’ post-operative pain. The clinical outcomes, patient’s quality of life, body image and cosmetic scores on follow up were also compared. RESULTS: The operating time were similar in both groups. The surgeon’s difficulty as measured in VAS was significantly more in group B in 4 out of 10 defined steps. The post-operative patient pain scores were similar till 48 hours following surgery (p 0.33), but following which the patients in group B had improved pain scores (p 0.0004). Analgesic requirement was similar in both arms (p 0.47). The warm ischemia times in group B (5.11 1.01 vs 7.15 1.84 minutes, p 0.0001) were longer but the total ischemia time in both groups were similar. All grafts had on-table urine output in the recipient. Intraoperative and post-operative complications in both groups were comparable. The patients in group B had shorter hospital stay (p 0.003). The eGFR of recipients at one year were comparable on both groups (80.87 22.12 vs 81.51 29.01 milliliters/minute, p 0.46). The donor’s quality of life, body image and cosmetic scores were comparable in both groups. CONCLUSIONS: LESS donor nephrectomy though challenging, reduces donor morbidity by providing early pain relief with shorter hospital stay and with comparable graft function.