Laparoscopic Live Donor Nephrectomy: The University of Maryland 3-Year Experience

Jacobs, Stephen C.; Cho, Eugene; Dunkin, Brian J.; Flowers, John L.; Schweitzer, Eugene J.; Cangro, Charles B.; Fink, Jeffrey C.; Farney, Alan C.; Philosophe, Benjamin; Jarrell, Bruce E.; Bartlett, Stephen T.

doi:10.1016/s0022-5347(05)67014-0

Cited by 229 publications

(73 citation statements)

References 3 publications

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“…Other studies of laparoscopic graft survival have shown results (91-95%) similar to those of our study [14,28,30]. The number of rejection episodes also did not differ significantly between the HALDN (8/118, 6.8%) and the ODN (7/123, 5.1%) groups (p=0.435), nor did other complications, such as ureteral complications (p=0.392).…”

Section: Discussionsupporting

confidence: 87%

Renal Function Recovery in Donors and Recipients after Live Donor Nephrectomy: Hand-Assisted Laparoscopic vs. Open Procedures

et al. 2010

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PurposeLaparoscopic donor nephrectomy is associated with less postoperative pain and faster recovery times in living kidney donors. However, pneumoperitoneum, which is required in laparoscopic donor nephrectomy, can result in adverse effects on renal function in donors and recipients. We compared renal function in donors and recipients after hand-assisted laparoscopic donor nephrectomy (HALDN) and open donor nephrectomy (ODN).Materials and MethodsBetween January 1997 and January 2008, 241 live donor nephrectomies were performed by either HALDN (n=118) or ODN (n=123). Preoperative patient characteristics were not significantly different between the donors and recipients. We monitored the changes in serum creatinine levels of the donors and recipients preoperatively and on postoperative days 1, 5, 28, 84, and 365.ResultsThe mean operative times of HALDN and ODN were 171 and 163 minutes (p=0.284), and the mean warm ischemic times were 292 and 236 seconds (p=0.207), respectively. The mean serum creatinine level in the recipients on postoperative day 1 was significantly higher after HALDN than after ODN (3.48 vs. 2.62 mg/dl, p=0.003). However, from postoperative day 5 to 1 year, there was no significant difference between the two groups. The mean serum creatinine level in the donors was not significantly different between the HALDN and ODN groups throughout the study period.ConclusionsRenal function recovery in the donors was similar with both HALDN and ODN. Graft renal function recovery after HALDN was comparable with that after ODN, except immediately after surgery (postoperative day 1).

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Section: Discussionsupporting

confidence: 87%

Renal Function Recovery in Donors and Recipients after Live Donor Nephrectomy: Hand-Assisted Laparoscopic vs. Open Procedures

et al. 2010

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“…Tributaries of the left renal vein, and especially the posterior lumbar branches, are of potential surgical importance if they are noted to be enlarged. The left kidney is preferred for laparoscopic donor nephrectomy due to the longer renal venous pedicle; however, a right nephrectomy may be performed if complex vascular anatomy precludes resection of the donor's left kidney (8). …”

Section: Normal Renal Vascular Anatomymentioning

confidence: 99%

The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

2010

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The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

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“…Jacobs et al reported the initial 3-year experience at the University of Maryland. 2 Among 320 consecutive laparoscopic live donors, the mean ischaemia time was 2.5 min, and 98% of grafts showed immediate graft function. With increasing experience, the ureteric stricture rate, which was high in the initial reports, has decreased significantly by paying attention to preserving the ureteric blood supply.…”

Section: Discussionmentioning

confidence: 99%

“…To reduce the morbidity of donors, who are healthy individuals, laparoscopic donor nephrectomy (LDN) is increasingly accepted as a safe and preferred surgical option. [1][2][3][4] However, the overall number of renal transplants in Hong Kong remains low. From 2006 to 2009, 262 deceased donor renal transplants were carried out; in comparison, 30 live donor transplants were carried out during that period.…”

mentioning

confidence: 99%

Laparoscopic live donor nephrectomy: Current practice and results of renal transplantation

Yip¹,

Leung

Szeto

et al. 2012

Surgical Practice

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Objective: In 2009, 1659 patients with end‐stage renal failure in Hong Kong were waiting for a renal transplant. The overall number of renal transplants carried out locally remains low, with an even lower number being live donor donations. Yet, live donor kidney transplantation yields results that are consistently superior to those of deceased donor kidney transplantation, and laparoscopic donor nephrectomy (LDN) is increasingly accepted worldwide as a safe and preferred surgical option. We aim to evaluate the outcome of LDN in our setting, and to compare with that of deceased donors in this retrospective review. Patients and Methods: A total of 12 patients received LDN over the study period of 2006–2009. Standard left transperitoneal LDN was carried out. Grafts including three with double vessels were prepared using the bench technique. The postoperative outcomes up to 1 year for both the donors and the recipients were studied. Contemporary results for the 47 deceased donor kidneys were studied and compared. Results: All donors had an eventful recovery. The operating time was 225.0 ± 67.4 min. The hospital stay was 5.6 ± 2.3 days. The recipient outcomes including hospital stay and creatinine levels at discharge and 1 year were 11 days, 121 umol/L and 116 umol/L, respectively. Specifically, no ureteric stricture or graft loss was noted at the 1‐year follow up. Recipient complications included haematoma (1 patient), renal artery stenosis (1 patient) and redo of vascular anastomosis (1 patient). In contrast, the deceased donor graft recipients had a hospital stay of 11 days, and creatinine levels of 205 umol/L on discharge and 205 umol/L at 1 year, respectively. The delayed graft function rates for the live donor and deceased donors group were 0% and 14.9%, whereas the 1‐year graft survival rates were 100% and 87.2% respectively. Conclusion: The results showed that the donor morbidity rate was low, as reflected by the short hospital stay. Also, the overall parameters of recipients were good. In particular, no ureteric stricture was noted, and graft survival was 100% at 1 year. Living donor kidney transplant program using the laparoscopic technique is a viable option to improve the pool of kidneys for transplantation.

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Laparoscopic Live Donor Nephrectomy: The University of Maryland 3-Year Experience

Abstract: Laparoscopic donor nephrectomy appears to be safe and decreases morbidity in the renal donor. Allograft function is comparable to that in open nephrectomy series. The availability of laparoscopic harvesting may be increasing the living donor volunteer pool.

Cited by 229 publications

References 3 publications

Renal Function Recovery in Donors and Recipients after Live Donor Nephrectomy: Hand-Assisted Laparoscopic vs. Open Procedures

Renal Function Recovery in Donors and Recipients after Live Donor Nephrectomy: Hand-Assisted Laparoscopic vs. Open Procedures

The Utility of 64 Channel Multidetector CT Angiography for Evaluating the Renal Vascular Anatomy and Possible Variations: a Pictorial Essay

Laparoscopic live donor nephrectomy: Current practice and results of renal transplantation

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