EVALUATION OF RESULTS OF LAPAROSCOPIC DONOR NEPHRECTOMY

Abstract

Context: Chronic kidney disease is a major cause of mortality and morbidity in the world today. Diseases like diabetes mellitus, hypertension and glomerulonephritis more commonly lead to CKD, which in later stages (stage V CKD) may require renal replacement therapy through hemodialysis, peritoneal dialysis or renal transplant. Renal transplantation offers best form of renal replacement therapy. It can be performed by open or laparoscopic methods. Laparoscopic donor nephrectomy is associated with decrease post operative pain, lesser duration of hospitalization, etc. for donors, thus, leading to more number of people opting for kidney donation and augmenting the donor pool. To assess the impact of laparoscopic donor nephrectomy on graft func Aims: tion in recipient of kidney transplantation and to evaluate the advantages of laparoscopic surgery on donor. Settings and Design: A prospective observational study conducted at a tertiary care hospital of New Delhi. A total of 33 transpla Methods and Material: nt pairs were studied. Results of laparoscopic donor nephrectomies were assessed by graft function and donor well being. We studied operative time, warm ischemia time, length of hospitalization, post operative pain and return to work in donors and graft function along with time taken by serum creatinine to normalize in recipients. Statistical analysis used: Data entry was done on Microsoft Excel and was analysed over SPSS version 21.0. A short Results: duration of hospitalisation, low analgesics requirement, lesser post-operative pain, early oral intake, small scar, less chances of wound infection and better cosmesis were seen with laparoscopic donor nephrectomy. We observed that mean duration of donor nephrectomy was 365±73.09 mins with blood loss of 150ml and rst warm ischemia time of 6±0.92mins. Two patients had delayed graft function (DGF). Trend in serum urea and creatinine normalization and post-transplant urine outputs were similar to open donor nephrectomy group. Laparoscopic Conclusions: donor nephrectomy as a minimally invasive procedure is safe and effective. It leads to short hospitalisation, less post-operative pain, better cosmesis etc. for donor without affecting immediate or late graft function in recipient.