Calculating Additional Risk of Concomitant Laparoscopic Surgery in Living Kidney Donors: Cholecystectomy in Combination with Living Donor Nephrectomy

Abstract

Background: During the evaluation of a donor candidate for living kidney donation, occasionally a concomitant benign abdominal disease is diagnosed. Combining organ donation and surgical treatment of that disease could be beneficial to the donor. This paper quantified the additional risk to the donor if the two operations were combined. Study design: The clinical database of 155 academic medical centers and affiliated hospitals of University HealthSystem Consortium was used to predict the minimum expected surgical risk of a combined laparoscopic cholecystectomy and laparoscopic donor nephrectomy. Results: Our model predicted that a minimum of 8.64% of patients undergoing laparoscopic cholecystectomy at the same time as a donor nephrectomy would experience at least one complication. This represents an increase of 2.3% (relative risk=1.24) from the 6.34% risk for patients undergoing only the cholecystectomy. Conclusion: The estimation of increased risk is a necessary step to obtain informed consent from a donor offered or who wants to undergo multiple procedures simultaneously.