Laparoscopic Donor Nephrectomy for Pediatric Kidney Transplantation: The Short Term Results

Abstract

Aim: Laparoscopic kidney procurement in adults is safe. However the impact of this procedure on early graft function and survival in pediatric kidney recipient remains unclear. The aim of this study was to determine the surgical and functional outcomes of laparoscopic graft procurement in pediatric renal transplant recipients. Patients and methods: Twelve pediatric laparoscopic living donor renal transplant recipients operated between October 2010 and January 2012 were retrospectively reviewed in terms of demographics, etiology of end stage renal diseases (ESRD), operative complications, length of hospital stay, early graft function, graft and patient survival. Results: The mean age was 11.45±6,3 (range: 1,5-18) years in recipients and was 43,3 ±10,8 (range: 27-61) years in donors. Median donor operation time was 124 minutes (range: 110-135 min). All donors were discharged between 36 to 48 hours after nephrectomy. There was no surgical and medical complication in donors. Etiologies of ESRD were nephrotic syndrome in four, cystinosis in two, vesicoureteral reflux in four, unknown in two patients. The mean of warm ischemia time was 131± 21 seconds and cold ischemia time was 48,0±12,9 minutes. Mean follow up was 7,0 ±3,9 months. The mean serum creatinin levels (mg/dl) on first day after operation was 1,76±1,4, at the time of discharge was 0,72±0,4 and currently is 0,86±0,5. Mean hospitalization time was 10,1±4,8 days. One patient had urinary tract infection. It was controlled by appropriate antibiotic treatment. No acute rejection and surgical complication was observed in recipients. Graft survival rates were 100%. No mortality occurred in the pediatric recipients. Conclusion: Laparoscopic donor nephrectomy seems safe and effective in our group of pediatric kidney transplant recipients.