Evolution of Laparoscopic Live Donor Nephrectomy: A Single-Center Experience with 1510 Cases over 14 Years

Simforoosh, Nasser; Soltani, Mohammad Hossein; Basiri, Abbas; Tabibi, Ali; Gooran, Shahram; Sharifi, Seyed Hossein Hosseini; Shakibi, M.

doi:10.1089/end.2013.0460

Cited by 24 publications

(16 citation statements)

References 30 publications

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“…It has been suggested that heparin administration during donor nephrectomy should be avoided due to increased bleeding complications . In our series, no intra‐operative or postoperative bleeding complications occurred due to heparin administration.…”

Section: Discussionmentioning

confidence: 57%

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The safety of hand‐assisted laparoscopic living donor nephrectomy: The Ohio State University experience with 1500 cases

Rajab

Pelletier

2015

Clinical Transplantation

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Hand-assisted laparoscopic donor (HALD) nephrectomy has been performed at our institution since December 1999. Through May 2014, a total of 1500 HALD procedures have been performed. We have evaluated the outcomes of HALD. The HALD procedure consists of a hand-port incision as well as two 12-mm ports. Mean donor age was 40.8 ± 10.8 yr, BMI was 27.9 ± 5.0, there were 541 males, 1271 Caucasians, and the left kidney was removed in 1236 patients. All procedures were successfully completed. Four donors (0.27%) were converted to an open technique due to bleeding. Four donors required blood transfusions. 53 donors (3.5%) were readmitted in the first month post-donation; almost half were due to gastrointestinal complaints. Six donors required reoperation; three for SBO and three for wound dehiscence. 27 patients (1.8%) developed incisional hernias. Seven donors (0.47%) developed bowel obstruction. All donors recovered well with a mean hospital stay after donation of 2.1 ± 0.3 d. All except one kidney were successfully implanted. Twenty-one recipients (1.4%) experienced DGF. Ureter complications occurred in 17 (1.1%) recipients. Early graft loss occurred in 13 patients (0.9%). In conclusion, HALD is a safe procedure for the donor with good recipient outcomes.

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Section: Discussionmentioning

confidence: 57%

“…, the total and major complication rates in LSD were 10.3% and 4.5%, respectively. A large single‐center study of 1510 LSD procedures reported a 0.6% conversion rate .…”

Section: Discussionmentioning

confidence: 99%

The safety of hand‐assisted laparoscopic living donor nephrectomy: The Ohio State University experience with 1500 cases

Rajab

Pelletier

2015

Clinical Transplantation

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“…Using bipolar cauterizing, we have not seen 1 case of lymph leakage after more than 1500 laparoscopic donor nephrectomy. 17,18 Prevention is important, above all using bipolar coagulation. It has been shown in animal 19 and human studies 20 that bipolar coagulation can effectively occlude lymph channels.…”

Section: Discussionmentioning

confidence: 99%

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Guglielmo

Melandro

Nudo

et al. 2016

Exp Clin Transplant

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Laparoscopic donor nephrectomy is an established operation for organ procurement in living-donor transplant. Minimal access approach for organ procurement from living donors ensures early convalescence and improved patient participation. Chylous leakage is a rare complication of laparoscopic living-donor nephrectomy. Chylous leakage is mostly determined by iatrogenic injury of cisterna chyli and its main tributaries. It may lead to malnutrition and immunologic deficits because of protein and lymphocyte depletion.An 18-year-old woman underwent left-handassisted laparoscopic donor nephrectomy for living donor transplant. She developed chylosus leakage in third postoperative day. A conservative manage-ment with total parenteral nutrition total paren-teral nutrition and subcutaneous somatostatin was immediately initiated. The patient had an abatement of drainage daily output in 4 days of therapy. Chylous leakage is a potentially insidious and perhaps misdiagnosed complication of laparoscopic donor nephrectomy. Conservative therapy is effective in most donors and should be initially attempted. Surgical ligatures or fibrin sealants may be indicated in case of refractory chylous leakage before the arising of malnutrition and/or relevant immunodeficiency.

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“…We considered that several modifications used for right donor nephrectomy and recipients played an important role in improving the safety and efficacy of right laparoscopic living-donor nephrectomy by prolonging the vein length with inverted kidney transplant, 30 the use of hand-assisted devices, and use of a modified Satinsky atraumatic vascular clamp. 31 However, compared with left laparoscopic living-donor nephrectomy, the modifications did not decrease the operative difficulty significantly and made the operation less demanding for the urologists.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Evolution of Laparoscopic Live Donor Nephrectomy: A Single-Center Experience with 1510 Cases over 14 Years

Cited by 24 publications

References 30 publications

The safety of hand‐assisted laparoscopic living donor nephrectomy: The Ohio State University experience with 1500 cases

The safety of hand‐assisted laparoscopic living donor nephrectomy: The Ohio State University experience with 1500 cases

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