Article

Laparoscopic donor nephrectomy yields kidneys with structure and function equivalent to those retrieved by open surgery.

University of Leicester, Leicester, UK.
Transplantation Proceedings (impact factor: 1). 03/2005; 37(2):625-6. DOI:10.1016/j.transproceed.2004.12.292 pp.625-6
Source: PubMed

ABSTRACT The technical challenges of laparosopcic transperitoneal donor nephrectomy (LapDN) have raised concerns over the quality of the procured allografts. This study reports the anatomical and functional outcomes of kidneys retrieved from 60 live donors entered into a randomized controlled trial of open versus laparoscopic procurement. Open and laparoscopic donors were well matched for age (P = .18) and body mass index (P = .49). Operating time (P = .0001) and first warm ischaemic time (P < .001) were longer for the laparoscopic donors but total warm time was not different (P = .52). Left renal vein length (P = .14) and left renal artery length (P = .38) were similar. No differences in right vessel length were observed. Rates of acute rejection did not differ, and recipient renal function was similar in the two groups. This study demonstrates that LapDN yields kidneys that are structurally and functionally equivalent to those acquired by the open operation. This data may go some way towards allaying concerns over the effect of laparoscopic procurement on live donor kidneys.

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    A Srivastava, N Gupta, Anant Kumar, Rakesh Kapoor, Deepak Dubey
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    ABSTRACT: Renal transplantation is the treatment of choice for a suitable patient with end stage renal disease. Unfortunately, the supply of donor organs is greatly exceeded by demand. In many countries the use of kidneys from living donors has been widely adopted as a partial solution. Traditionally donor nephrectomy has been performed via a open flank incision however with some morbidity like pain and a loin scar. Currently, the donor nephrectomy is increasingly being performed laparoscopically with the objective of reducing the morbidity. It is also hoped that this will lead to increasing acceptance of living donation. The first minimally invasive living donor nephrectomy was carried out in 1995 at the Johns Hopkins Medical Center and since then many centers have undertaken laparoscopic living donor nephrectomy. The laparoscopic approach substantially reduces the donor morbidity and wound related problems associated with open nephrectomy. The laparoscopic techniques thus have the potential to increase the number of living kidney donors. The present article attempts to review the safety and efficacy of transperitoneal laparoscopic donor nephrectomy.
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    Pranjal Modi, Krishnaprasad Thyagaraj, Syed Jamal Rizvi, Jigish Vyas, Sukant Padhi, Kamlesh Shah, Ram Patel
    [show abstract] [hide abstract]
    ABSTRACT: Laparoscopic donor nephrectomy is well establish procedure and having advantages over open donor nephrectomy in terms of having less pain, early ambulation and rapid post operative recovery. To extend the advantages of laparoscopic surgery to the recipient, recently we have performed laparoscopic kidney transplantations when kidney was procured from deceased donors. As a further extension of the procedure, here we present a case of laparoscopic en bloc kidney transplantation in obese diabetic recipient who received kidneys from 70 year old non-heart beating donor.
    Indian Journal of Urology 07/2012; 28(3):362-5.
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Keywords

acute rejection
 
anatomical
 
body mass index
 
differences
 
first warm ischaemic time
 
functional outcomes
 
functionally equivalent
 
laparosopcic transperitoneal donor nephrectomy
 
LapDN yields kidneys
 
Open
 
open operation
 
procured allografts
 
randomized
 
recipient renal function
 
renal artery length
 
technical challenges
 
two groups