Implementation and learning of laproscopic donor nephrectomy by a non-transplant general surgeon with advanced laparoscopic skills

Voskoboinik, Aleksandr; Gutman, Matthew; Croagh, Daniel; Bell, Roger; Saunder, Alan; Gribbin, John; Kanellis, John

doi:10.1111/j.1758-5910.2011.00092.x

Cited by 1 publication

(3 citation statements)

References 17 publications

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“…eGFR = estimated glomerular filtration rate; CKD-EPI = chronic kidney disease epidemiology collaboration; GFR = radionuclide glomerular filtration rate. a Ethnicity (see Table S5, in Supplemental Digital Content 1). b Obtained using the formula CKD-EPI eGFR. c 774 (74%) living kidney donors underwent a radionuclide glomerular filtration rate measurement. d Participants completed home blood-pressure measurements following a standardized protocol. e Hypertension 31,32 (see Table S2, in Supplemental Digital Content 1). f Body mass index measured within 30 days before donor surgery (see Table S6, in Supplemental Digital Content 1).…”

Section: Resultsmentioning

confidence: 99%

“…We also surveyed 90% of the surgeons who performed the nephrectomies for donors in this study; few prior studies have examined the characteristics of surgeons performing living donor nephrectomies and whether these characteristics associate with perioperative complications. 31,32,38,39…”

Section: Discussionmentioning

confidence: 99%

“…25,26 b Rates were computed using predictive margins from a multivariable logistic regression model and compared between groups; the percentage of complications for smokers and nonsmokers was significantly different ( P = .0305). For donor characteristics, where the number of events in one or more of the groups is <5, exact confidence intervals were computed. c Donor is a biologic parent, sibling, offspring, grandparent, grandchild, aunt, uncle, niece, nephew, or cousin of the recipient. d Emotionally related includes spousal donors. e Hypertension 31,32 (see Table S2, in Supplemental Digital Content 1). f Weight was measured within 30 days before the donor’s nephrectomy.…”

Section: Perioperative Complications In Relation To Donor Characterismentioning

confidence: 99%

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Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study

Garcia-Ochoa

Feldman

Nguan

et al. 2019

Can J Kidney Health Dis

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Background: While living kidney donation is considered safe in healthy individuals, perioperative complications can occur due to several factors. Objective: We explored associations between the incidence of perioperative complications and donor characteristics, surgical technique, and surgeon’s experience in a large contemporary cohort of living kidney donors. Design: Living kidney donors enrolled prospectively in a multicenter cohort study with some data collected retrospectively after enrollment was complete (eg, surgeon characteristics). Setting: Living kidney donor centers in Canada (n = 12) and Australia (n = 5). Patients: Living kidney donors who donated between 2004 and 2014 and the surgeons who performed the living kidney donor nephrectomies. Measurements: Operative and hospital discharge medical notes were collected prospectively, with data on perioperative (intraoperative and postoperative) information abstracted from notes after enrollment was complete. Complications were graded using the Clavien-Dindo system and further classified into minor and major. In 2016, surgeons who performed the nephrectomies were invited to fill an online survey on their training and experience. Methods: Multivariable logistic regression models with generalized estimating equations were used to compare perioperative complication rates between different groups of donors. The effect of surgeon characteristics on the complication rate was explored using a similar approach. Poisson regression was used to test rates of overall perioperative complications between high- and low-volume centers. Results: Of the 1421 living kidney donor candidates, 1042 individuals proceeded with donation, where 134 (13% [95% confidence interval (CI): 11%-15%]) experienced 142 perioperative complications (55 intraoperative; 87 postoperative). The most common intraoperative complication was organ injury and the most common postoperative complication was ileus. No donors died in the perioperative period. Most complications were minor (90% of 142 complications [95% CI: 86%-96%]); however, 12 donors (1% of 1042 [95% CI: 1%-2%]) experienced a major complication. No statistically significant differences were observed between donor groups and the rate of complications. A total of 43 of 48 eligible surgeons (90%) completed the online survey. Perioperative complication rates did not vary significantly by surgeon characteristics or by high- versus low-volume centers. Limitations: Operative and discharge reporting is not standardized and varies among surgeons. It is possible that some complications were missed. The online survey for surgeons was completed retrospectively, was based on self-report, and has not been validated. We had adequate statistical power only to detect large effects for factors associated with a higher risk of perioperative complications. Conclusions: This study confirms the safety of living kidney donation as evidenced by the low rate of major perioperative complications. We did not identify any donor or surgeon characteristics associated with a higher risk of perioperative complications. Trial registration(s): NCT00319579: A Prospective Study of Living Kidney Donation ( https://clinicaltrials.gov/ct2/show/NCT00319579 ) NCT00936078: Living Kidney Donor Study ( https://clinicaltrials.gov/ct2/show/NCT00936078 )

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Perioperative Complications In Relation To Donor Characterismentioning

confidence: 99%

See 1 more Smart Citation

Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study

Garcia-Ochoa

Feldman

Nguan

et al. 2019

Can J Kidney Health Dis

View full text Add to dashboard Cite

show abstract

Implementation and learning of laproscopic donor nephrectomy by a non-transplant general surgeon with advanced laparoscopic skills

Cited by 1 publication

References 17 publications

Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study

Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study

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