Anterior vertical mini-incision vs. retroperitoneoscopic nephrectomy in living kidney donation: a prospective study on donors' quality of life and clinical outcome

Clin Transplant. 2015 Nov;29(11):1029-38. doi: 10.1111/ctr.12625. Epub 2015 Oct 5.

Abstract

Background: A fundamental goal in living kidney donation (LKD) is to maximize donor safety while minimizing post-operative impairments. We evaluated clinical outcome and health-related quality of life (QOL) comparing anterior vertical mini-incision donor nephrectomy (MIDN) and retroperitoneoscopic donor nephrectomy (RPDN).

Methods: Thirty-eight MIDN and 45 RPDN donors were analyzed. In a subsample (n = 18 MIDN; n = 32 RPDN), QOL was prospectively assessed with the WHOQOL-Bref questionnaire before and three months after LKD.

Results: Skin-to-skin time (169 vs. 116 min, p < 0.001) and hospital stay (6.6 vs. 4.9 d, p < 0.001) were significantly shorter in RPDN. In total, 26% of MIDN patients and 13% of RPDN patients developed post-operative complications (p = 0.14). While in MIDN the QOL domains physical health (p = 0.03) and psychological (p = 0.03) and the overall QOL facet (p = 0.003) were significantly lower three months post-LKD compared to baseline, there were no significant QOL decreases in RPDN. However, no significant post-operative QOL differences were found between groups. RPDN donors retrospectively reported significantly less post-operative pain (p = 0.007) and physical strain (p = 0.05) caused by LKD than MIDN donors.

Conclusions: It may be possible to further reduce the surgical burden of LKD by introducing RPDN. Post-operative QOL was not significantly different between groups, but the QOL decrease appeared to be less pronounced in RPDN.

Keywords: WHOQOL-Bref; living kidney donation; mini-incision donor nephrectomy; prospective study; quality of life; retroperitoneoscopic donor nephrectomy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Laparoscopy
  • Length of Stay
  • Living Donors*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Nephrectomy / methods*
  • Postoperative Period
  • Prognosis
  • Prospective Studies
  • Quality of Life*
  • Retroperitoneal Space / surgery*
  • Tissue and Organ Harvesting / methods*