Hand-Assisted Laparoscopic Nephrectomy for Live Donor Kidney Transplantation

Transplant Proc. 2016 Mar;48(2):568-71. doi: 10.1016/j.transproceed.2016.02.020.

Abstract

Introduction: The live donor nephrectomy is an unusual surgical procedure as it is performed on healthy individuals. It is important to make the procedure as safe as possible without compromising the health of the donor and graft function.

Justification: In Mexico during 2014, 2610 kidney transplantations performed, and 1862 grafts were from living donors.

Objective: We describe our experience with hand-assisted laparoscopic nephrectomy on live donors for kidney transplantation.

Materials and methods: We present a descriptive and observational study in which all living donors who completed the study protocol for renal transplantation are included.

Results: From September 2006 to July 2015, there were 238 hand-assisted laparoscopic nephrectomies with live donors; 227 (95.37%) were performed on the left side and 11 (4.63%) on the right side. Of donors, 54.1% were females. The average values for the variables analyzed were age 38.17 years, 25.94 BMI, creatinine 0.82-1.13 mg/dL pre- and postoperative month respectively, length of stay 4.95 (range 2-8), warm ischemia 5.07 (range 3-13) minutes, surgical time 168.85 minutes (range 90-306), and transsurgical bleeding 139 055 mL (range 25-650). One patient was reoperated for abdominal pain and bloating without evidence of pathology, attributing it to metabolic ileus. Two patients were converted to open surgery; 1 by technical problems with the laparoscopic equipment and the second by bleeding from the renal vein, both with good results.

Discussion and conclusions: Laparoscopic nephrectomy is a safe method that allows kidney donors to have a speedy recovery without modifying the survivals of renal grafts.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Hand-Assisted Laparoscopy / methods*
  • Humans
  • Kidney Transplantation / methods*
  • Laparoscopy / methods
  • Living Donors*
  • Male
  • Mexico
  • Middle Aged
  • Nephrectomy / methods*
  • Operative Time
  • Tissue and Organ Harvesting / methods*