Evaluating graft function in pediatric recipients for living donor renal transplantation: Is laparoscopic donor nephrectomy safe?

Abstract

Objective:To evaluate the surgical and functional outcomes of laparoscopic graft procurement in pediatric patients undergoing renal transplantation.Materials and Methods:A retrospective chart review of the cohort records of 54 pediatric living donor renal transplant recipients from 1985 through June 2006 was performed. We compared results of laparoscopic donor nephrectomy (LDN, n = 15) and open donor nephrectomy (ODN, n = 39). Parameters analysed included donor technique and morbidity, operative complications, immediate postoperative renal function, the incidence of early and delayed graft function, and long-term graft survival.Results:The mean age of these recipients was 14.8 years (5-18) in the LDN group and 13.9 years (8-18) in ODN group. Serum creatinine (mg/dl) was 1.5 ± 0.7 vs 1.8 ± 1.3 at day 1 (P = 0.20), 1.0 ± 0.3 vs 1.4 ± 1.3 at day 2 (P = 0.12), 1.1 ± 0.9 vs 1.3 ± 1.0 at day 7 (P = 0.25), 1.2 ± 0.5 vs 1.6 ± 1.8 (P = 0.20) at day 14, 1.1 ± 0.7 vs 1.2 ± 1.4 (P = 0.39) at 1 month in LDN vs ODN groups, respectively. Early graft function was 35.7 vs 46.4% in the respective groups. There were two delayed graft function and one graft nonfunction in ODN group. Over all graft and patient survival at 1 year was 86.67 and 82.22% (P = 0.34) in LDN and ODN groups, respectively.Conclusion:Pediatric recipients of the LDN grafts have outcomes comparable to those of ODN graft recipients. Laparoscopic donor nephrectomy is safe and efficacious for graft procurement for pediatric recipients.