Abstract
Background: Laparoscopic donor nephrectomy represents a significant source of allografts to patients with end- stage renal disease. Given the increasing wait-list and limited number of deceased donors, utilization of the right kidney is necessary to maximize the donor pool. Materials: We retrospectively reviewed 122 right-sided kidney donors; 73 hand-assisted laparoscopic donor nephrectomies (R-HAL-DN), 36 standard laparoscopic donor nephrectomies (R-LAP-DN), and 13 laparoendoscopic single site donor nephrectomies (R-LESS-DN). We compared these groups to matched left donors and each other, analyzing various parameters including operative times, warm ischemia time (WIT), estimated blood loss (EBL), incision length, length of stay (LOS), convalescence data and complications. Results: Right and left donors demonstrated no difference in analysis parameters in all 3 procurement techniques. When comparing all right donors total operative time and allograft extraction time were lowest in the R-LAP-DN group (p=0.003 & p=0.04, respectively). The R-LESS-DN group had the lowest EBL (p=0.06) and shortest incision length (p<0.0001). The LOS was shortest in the R-LAP-DN group (p=0.03). WIT, donor convalescence, and recipient allograft function were similar in all 3 groups. Conclusion: Our data demonstrates the safety and reproducibility of procuring the right kidney. Donor safety and allograft function have continued through evolution of the technique.
Highlights
The transition from open to laparoscopic donor nephrectomy (LAP-DN) at most high volume kidney transplant centers began in 1995 after Ratner et al reported the first successful laparoscopic living renal allograft recovery [1]
Donor safety and allograft function have continued through evolution of the technique
Several studies have shown that right kidneys procured via traditional hand-assisted or standard laparoscopic methods have shown equivalent function compared to a matched group of left sided allografts [5,8,9,10,11]
Summary
The transition from open to laparoscopic donor nephrectomy (LAP-DN) at most high volume kidney transplant centers began in 1995 after Ratner et al reported the first successful laparoscopic living renal allograft recovery [1]. Several studies have shown that right kidneys procured via traditional hand-assisted or standard laparoscopic methods have shown equivalent function compared to a matched group of left sided allografts [5,8,9,10,11]. Materials: We retrospectively reviewed 122 right-sided kidney donors; 73 hand-assisted laparoscopic donor nephrectomies (R-HAL-DN), 36 standard laparoscopic donor nephrectomies (R-LAP-DN), and 13 laparoendoscopic single site donor nephrectomies (R-LESS-DN). We compared these groups to matched left donors and each other, analyzing various parameters including operative times, warm ischemia time (WIT), estimated blood loss (EBL), incision length, length of stay (LOS), convalescence data and complications
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