Laparoscopic donor nephrectomy - safety in a small-volume transplant center.

Abstract:

INTRODUCTION:Laparoscopy is a standard surgical option for live donor nephrectomy (LDN) at the majority of transplant centers. Equivalent graft survival with shorter convalescence has been reported by several large volume centers. With the arrival of an experienced laparoscopic surgeon in 2002, we began to offer laparoscopic LDN at our institution. We report our experience as a large volume laparoscopic surgery program but a low volume transplant center. METHODS:A retrospective review of the previous 34 LDN (17 open, 17 laparoscopic) performed at the University of Missouri were included. A single laparoscopic surgeon performed all laparoscopic procedures. Hand assisted laparoscopy was performed in 15 and standard laparoscopy with a pfannenstiel incision in two. Open procedures were performed through anterior subcostal or flank incision. A single surgeon performed all open procedures. RESULTS:There was no statistical difference in age, body mass index or American Society of Anesthesiologies Score between the two groups. Mean operative time, estimated blood loss and hospital stay were 229 minutes, 324 cc and 2.2 days respectively in the laparoscopic group compared to 202 minutes, 440 cc and five days for the open group. Average warm ischemia time was 179 seconds. Recipient creatinine for the two groups at one week, one month and one year was not statistically significantly different. Each group had one graft loss due to medication noncompliance. CONCLUSION:For small transplant centers with an advanced laparoscopic program, laparoscopic LDN is a safe procedure with comparable outcomes to major transplant centers.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Riley J,Troxel S,Wakefield M,Ross G,Weinstein S

doi

10.1111/j.1399-0012.2009.01153.x

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

429-32

issue

3

eissn

0902-0063

issn

1399-0012

pii

CTR1153

journal_volume

24

pub_type

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