Standardization of Laparoscopic Donor Nephrectomy Technique in Minimizing Ureteral Complications in Renal Transplant Recipients: 10-Year Experience of a Single Center

Abstract

BackgroundLaparoscopic donor nephrectomy (LDN) is the preferred method for kidney retrieval in live donor kidney transplantation. The surgical technique of LDN has improved over the years, but ureteral complications are still common after kidney transplantation. The relationship between the surgical technique in LDN and ureteral complications has been debated. This study aims to discuss ureteral complications and risk factors in kidney transplantation in a group of patients performed with a standard technique. Materials and MethodsA total of 751 live donor kidney transplantations were included in the study. Age, sex, body mass index, concomitant metabolic diseases, nephrectomy side, multiple renal arteries, and several complete or incomplete duplicated ureters of donors were recorded. The recipient's age, sex, body mass index, duration of dialysis, the daily volume of urine before transplantation, accompanying metabolic diseases, and postoperative ureteral complications were also recorded. ResultsOf the 751 patient donors included in the study, 433 (57.7%) were female, and 318 (42.3%) were male. Of the 751 recipients, 291 (38.7%) were female, and 460 (61.3%) were male. In the 751 recipients, there were 8 (1.0%) ureteral complications, all of which were ureteral strictures. No ureteral leaks or urinomas were noted in this series. There was no statistically significant relation between donor age, donor body mass index, donor side, presence of hypertension in the donor, presence of diabetes mellitus in the donor, or ureteral complications. The mean duration of dialysis and preoperative daily urine volume were associated with increased ureteral complications with statistical significance. ConclusionRecipient factors may affect ureteral complication rates in live donor kidney transplantation, donor nephrectomy technique, and gonadal vein preservation.