Laparoscopic live-donor nephrectomy. functional results in the pediatric recipient

Abstract

Purpose The impact of Laparoscopic Donor Nephrectomy (LDN) vs. Open Donor Nephrectomy (ODN) on early graft function and survival in pediatric kidney recipient remains unclear. Material and Methods We retrospectively review the records of 63 pediatric recipient of living donor renal transplant from 1994 to 2007. We compared those who received allograft by LDN (n:16) with those by ODN (n: 47). The mean recipient age was 9.3 ± 5 years and the mean donor age was 40.8 ± 7 years. Outcomes of interest included the incidence of delaye graft function, acute rejection and long-term graft function. Results Donor, recipient demographic data and the total time of cold ischemia (1.9 ± 0.3 hours) were similar in both groups. The mean of kidney warm ischemia was (195 LDN vs. 20 seconds ODN). There were not any significant differences between the two groups, neither in the patient survival after 36 months (100% LDN vs. 98% ODN), or in the graft survival (94% LDN vs. 93% ODN). The type of nephrectomy did not determine the graft survival with proportional hazards Cox analysis. The LDN group needed more days (9.56 ± 2.3 vs. 4.72 ± 0.57 ODN) to reach the minimum serum creatinine, but the GF (ml/min/1.73m2) was similar at 6 months (122 ± 24 LDN vs. 87 ± 17 ODN), one year (129 ± 45LDN vs. 88 ± 27 ODN) and two years (110 ± 64 LDN vs. 82 ± 30 ODN) after transplant. Conclusions LDN delays the recovery of the graft function in pediatric recipient. However, graft outcomes are comparable to those of ODN.