Abstract
Purpose and Methodology: Hand-assisted laparoscopic live donor nephrectomy (HALDN) has the benefits of quick operating time, short warm ischaemic time and fewer ureteric complications with possibly more safety for the donor [1, 2]. We aim to report the results of our HALDN cases performed at Prince of Wales Hospital, Sydney Australia. Results: Nine left-sided HALDN were completed successfully - two had dual arterial supply with all others having a single artery. We report an average warm ischaemic time (defined as the time from renal artery clamping until the end of perfusion) of 6.8 minutes (5–8 minutes) and operating time of 4.5 hours (3:43–5:30 hours). The mean length of stay was 4.4 days (3–6 days). No donors required blood transfusions or suffered any complications. Average urine production in the first day following the operation was 1.34 ml/kg/hr. No recipients needed dialysis or experienced ureteric complications and/or delayed graft function. There were two elective conversions to an open procedure – one due to a third renal artery that was not identified on preoperative imaging, the other due to insufficient vessel length. Conclusion: HALDN is the preferred technique because it is designed to minimise risk to the donor by facilitating direct control of bleeding, without the need for additional incisions or forfeiting graft function.
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