Hand-assisted laparoscopic living donor nephrectomy in living renal transplantation

Abstract

OBjective To evaluate the efficiency of hand-assisted laparoscopic technique for living donor nephrectomy in renal transplantation. Methods A total of 25 cases of living related kidney donors undergoing hand-assisted laparoscopic living donor nephrectomy (HLDN) were retrospectively analyzed. Of the 25 donors, with age of 42±17 years, 6 males and 19 females, 23 cases were livingrelated donors and the rest 2 spouse. Operative time, blood loss, warm ischemia time, renal or other organ injury during operation, the donors' postoperative hospital stay, the reasons to choose HLDN,and the function of the allograft were analyzed. Results The procedure was performed successfully in all 25 donors, and there was no conversion to open operation. Twenty-four cases received left side nephrectomy, and 1 case right. The mean operative time was 138±42 min, estimated blood loss 53±32 ml, and warm ischemia time 145±22 s. No renal injury occurred and there was one case of spleen injury during operation. No complications about incision occurred. The donors' postoperative hospital stay was 7.2±1.7 days. The main reasons to choose HLDN included less postoperative pain and cosmetic concerns. The recipient had normal renal function at the first week postoperation except one case who had delayed graft function. Conclusion HLDN combined the advantages of pure laparoscopic living donor nephrectomy and open donor nephrectomy. It is not only minimally invasive, safe, and fine cosmetic for donor, but also convenient in operation, and has no injury on allgraft. HLDN may be the first selective method for living donor nephrectomy in living renal transplantation in the future. Key words: Living donors; Nephrectomy; Laparoscopes; Kidney transplantation