Comparison of Both Sides for Retroperitoneal Laparoscopic Donor Nephrectomy: Experience From a Single Center in China

Qiu, Yang; Wang, X.; Song, Ting; Rao, Zhengsheng; Liu, J.; Huang, Zhongli; Lin, Tianhai

doi:10.1016/j.transproceed.2017.02.062

Cited by 9 publications

(14 citation statements)

References 21 publications

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“…Ma et al studied 19 right vs. 84 left retroperitoneoscopic nephrectomy patients, and found that right nephrectomy was safe and cost effective. This finding is supported by a recent and so far the largest series from China consisting of 104 right vs. 423 left retroperitoneoscopic nephrectomy patients [6]. In the present retrospective analysis, assessed the efficacy and safety of right retroperitoneoscopic LDN in 81 cases.…”

Section: Introductionsupporting

confidence: 62%

“…The renal vein and the inferior vena cava are carefully dissected at their confluence (4). Then, the renal artery is clipped proximally (5), the renal vein is blocked at the confluence of the renal vein at the inferior vena cava and the renal vein is cut along with partial vena cava wall (6). The incision on the lateral wall of the inferior vena cava is then continuously sutured (7) and the vena cava after suturing is shown (8).…”

Section: Complicationsmentioning

confidence: 99%

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Safety and Efficacy of Right Retroperitoneal Laparoscopic Live Donor Nephrectomy: A Retrospective Single-Center Study

Wang

et al. 2020

Ann Transplant

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The aim of this study was to investigate the efficacy and safety of right retroperitoneal laparoscopic live donor nephrectomy (LDN) in 81 cases of living-related renal transplant. Material/Methods: We retrospectively reviewed all living-related donors who underwent right retroperitoneoscopic living donor nephrectomy between June 2010 and December 2017 at the First Hospital of Jilin University and their corresponding recipients. Demographic and clinical data were collected from the hospital's electronic clinical data system. Data on preoperative renal retention parameters, operative time, and donor kidney warm ischemia time, the trimmed length of the renal artery and vein of donor kidney, and the time to extubation were recorded. Complications in both donors and recipients were recorded. Results: We included 81 donors who underwent successful right-sided retroperitoneoscopic LDN, with 31 males and 50 females and a mean age of 47.1 years (range 21-63 years). There was no intraoperative conversion to open donor nephrectomy. The mean operative time was 120.68±29.8 min. The mean warm ischemic time was 49.26±3.86 s. The estimate blood loss was 54.32 mL (range 50-400 mL). The median length of hospital stay was 7 days (range 4-13 days). There was neither intraoperative complication such as hemorrhage or lymph fistula nor kidney graft injury. There was no graft renal vein thrombosis and ureteral stricture or other complications. No graft rejection occurred. Conclusions: Right retroperitoneal laparoscopic live donor nephrectomy is safe and effective for renal transplant in livingrelated renal transplant by laparoscopic excision and extraction of the right kidney with vena cava flap.

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Section: Introductionsupporting

confidence: 62%

Section: Complicationsmentioning

confidence: 99%

Safety and Efficacy of Right Retroperitoneal Laparoscopic Live Donor Nephrectomy: A Retrospective Single-Center Study

Wang

et al. 2020

Ann Transplant

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“…Of the 35 studies meeting the inclusion criteria, 34 were cohort studies and one was a RCT 31 ; 27 of the 35 were the LD studies, [5][6][7][8][9][10][11][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]54 6 were DD [14][15][16][17][18]51 and 2 had both living and deceased donors. [52][53] There was a total of 257,429 transplants (104,036 right donor and The overall quality of the LD studies was poor with 19 of the 26 studies deemed to be at high risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…We found no evidence that transplanting right kidneys impacts on recipient survival after transplantation. Only one 6 of the 8 LD studies 6,7,11,36,[45][46][47]52 and 3 14,16,18 of the 5 DD studies 14,[16][17][18]51 reporting patient survival provided sufficient time-to-event data.…”

Section: Recipient Survivalmentioning

confidence: 99%

Comparing outcomes in right versus left kidney transplantation: A systematic review and meta‐analysis

Carolan

Tingle

Thompson

et al. 2021

Clinical Transplantation

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Introduction: Transplantation of right kidneys can pose technical challenges due to the short right renal vein. Whether this results in inferior outcomes remains controversial.Method: Healthcare Database Advanced Search (HDAS) was used to identify relevant studies. Two authors independently reviewed each study. Statistical analyses were performed using random effects models and results expressed as HR or relative risk (RR) with 95% confidence intervals. Subgroup analyses were performed in kidneys from deceased donors (DD) and living donors (LD).Results: A total of 35 studies (257,429 participants) were identified. Both deceased and living donor right kidneys were at increased risk of delayed graft function (DGF; RR = 1.12[1.06-1.18] and RR = 1.33[1.21-1.46] respectively; both p < .0001). In absolute terms, for each 100 kidney pairs of DD kidneys transplanted there are 2.72 (1.67-3.78, p < .00001) excess episodes of DGF in right kidneys. Graft thromboses and graft loss due to technical failure was also significantly more likely in right kidneys, in both DD and LD settings. There was no evidence that laterality alters long term graft survival in LD or DD. Conclusion:Right kidneys have inferior early outcomes, with higher rates of DGF, technical failure and graft thrombosis. However, these differences are small in absolute terms, and long-term graft survival is equivalent.

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“…rLLDN has a steep learning curve. When surgeons get mastered the laparoscopy technique, complication rates and operation times may decrease in both lLLDN and rLLDN [27, 29]. Our results show that rLLDN median OT was longer than the lLLDN’s ( p = 0.046).…”

Section: Discussionmentioning

confidence: 78%

Laparoscopic Live Donor Nephrectomy: Experience of High-Volume Center with 2,477 Cases

et al. 2020

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Objective: Donors’ health and safety are mandatory in the living-donor kidney transplantation procedure. Laparoscopic live donor nephrectomy (LLDN) provides an increase in donor numbers with its benefits and becomes a standard of care. We aimed to explain the results, complication rates, tips, and tricks of the largest number of LLDN case series ever performed in the literature. Materials and Methods: Between August 2012 and December 2019, 2,477 live donor case files were analyzed retrospectively. Age, gender, hospitalization times, body mass index, warm ischemia times, operation times, numbers of arteries, side of the kidneys, and complications were noted. Results: 1,421 (57.4%) of 2,477 donors were female (p = 0.007). Operation times and warm ischemia times were found longer in right-sided LLDN and donors with multiple renal arteries (p = 0.046, <0.001, and <0.001, respectively). Obesity (BMI >30 kg/m2) did not affect warm ischemia times while prolonging the operation times (p = 0.013). Hospitalization times and numbers of complications were higher in obese donors. Conclusions: LLDN seems to be a reliable solution with fewer complications and higher satisfaction rates. We hope to illuminate the way with tips and trick points for beginner transplant surgeons based on the experience obtained from 2,477 LLDN cases.

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Comparison of Both Sides for Retroperitoneal Laparoscopic Donor Nephrectomy: Experience From a Single Center in China

Cited by 9 publications

References 21 publications

Safety and Efficacy of Right Retroperitoneal Laparoscopic Live Donor Nephrectomy: A Retrospective Single-Center Study

Safety and Efficacy of Right Retroperitoneal Laparoscopic Live Donor Nephrectomy: A Retrospective Single-Center Study

Comparing outcomes in right versus left kidney transplantation: A systematic review and meta‐analysis

Laparoscopic Live Donor Nephrectomy: Experience of High-Volume Center with 2,477 Cases

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