Intraoperative fluid management in laparoscopic live-donor nephrectomy: Challenging the dogma

Abstract

Lower volume fluid management strategies in LLDN do not appear to worsen recipient outcomes nor are they detrimental to the donors.

Beneficial Effects of a New Fluid Regime on Kidney Function of Donor and Recipient during Laparoscopic v Open Donor Nephrectomy

“…However, the delayed graft function was 18% in the restrictive fluid group v 10% in the liberal fluid group. 36 In the present study, more fluid was administered intraoperatively (13 mL/kg/h crystalloids and 12 mL/kg colloids in total), but delayed graft function occurred in only 2% after LDN.…”

The impact of intraoperative fluid management during laparoscopic donor nephrectomy on donor and recipient outcomes

“…8,26,27 Furthermore, no significant differences were observed in recipient postoperative complications, graft loss, and death among fluid management groups. These terms were decided after consultation and data interpretation with our expert anesthesiology colleagues.…”

“…4 Despite the safety and benefits of LDN, there is no consensus regarding the intraoperative fluid management required to optimize donor and recipient outcomes. 4,8,9 In addition, much of the literature is outdated and based on animal models. 4,8,9 In addition, much of the literature is outdated and based on animal models.…”

Ureteral Clipping Simplifies Hand-Assisted Laparoscopic Donor Nephrectomy

“…4 This raises the question of how beneficial and necessary fluid replacement and confirmation of a brisk diuresis from the transected ureter is during laparoscopic donor nephrectomy.…”

“…Bergman and colleagues 4 reported that renal donors receiving fluid-load (>10mL/kg/hr) and fluid-restriction (<10mL/kg/hr) did equally well in terms of postoperative creatinine levels and complications. Furthermore, there were no differences in recipient postoperative creatinine levels (to 12 months), delayed graft function, or acute rejection.…”