Experience with 247 living related donor nephrectomy cases at a single institution in Japan

Abstract

There is currently much concern over the morbidity and mortality of donors undergoing nephrectomy for living related renal transplants. Between April, 1970 and July, 1986, 247 cases of living related renal transplants were performed at the Second Department of Surgery, Kyoto Prefectural University of Medicine. The average age of the donors was 50.3 +/- 9.7 years, 81 per cent of the donors being parents of the recipients. Minor abnormalities which did not affect the donors suitability were found in 71 cases. Nephrectomies were performed extraperitoneally in all cases. Peri-operative complications, including wound complications in 13 cases, urinary infection in 12 cases and pulmonary complications and arrhythmia in 4 cases, were considered to be minor in nature. A variety of renal function tests, carried out two weeks after nephrectomy revealed normal levels, although they had become slightly worse than those estimated pre-operatively. Long-term sequelae in the follow-up period from 18 months to 16 years and 2 months, was studied on 124 donors who answered questionnaires. Currently, there are 5 late deaths, none of which are directly related to the nephrectomy. Of the 124 donors, 85.5 per cent stated that there had been no change in their physical states following surgery. Pain or a feeling of discomfort at the wound site was reported by 10 donors (8.1 per cent) and hypertension was observed only in 3 (2.4 per cent). No major complication directly related to the donor nephrectomy was found, except for one case of incisional hernia.(ABSTRACT TRUNCATED AT 250 WORDS)

Is Right Donor Nephrectomy Safe? Our Experience in Armed Forces Institute of Urology

“…In the experience of Yasumura and colleagues for 247 live related donor nephrectomies, again commonest perioperative complication was wound infection in 13 cases (5.3%) and only ten (8.1%) donors had mild but chronic scar pain. In long term sequel they reported postoperative hypertension in 2.4 percent (3 patients) 23 . Other authors also reported UTI (5%) and wound infections (4%) as the most common postoperative sequelae 20,24,25 .…”

Should laparoscopy be the standard approach used for radical nephrectomy?

“…Insurers in the United States have turned a blind eye to the nonquantifiable "costs" of an incision: acute and sometimes chronic discomfort, debility, disfigurement, muscle wall laxness, and herniation. In reviewing a series of patients undergoing open nephrectomy for renal transplantation, 8% of the donors noted ongoing flank discomfort beyond 18 months postoperative [32].…”

Recent advances in transplantation anesthesia and intensive care medicine

“…Transient facial and conjunctival edema occurs in some patients postoperatively, but it is benign and temporary in nature. Long-term complications are rare and include persistent wound pain in 8.1% and incisional hernia in 1% of the patients (37). Perioperative mortality is reported to be 0.03% to 0.06% and is similar to the risk of death in a motor vehicle accident during a 4-year interval (38)(39)(40).…”