Outcomes after 20 years of experience in minimally invasive living-donor nephrectomy

Felip, M. Musquera; Peri, Lluís; D’Anna, M.; Ajami, Tarek; Ribal, María J.; Vilaseca, Antoni; Revuelta, Ignacio; Álvarez-Vijande, R.; Palacios, Ana Redondo; Diekmann, Fritz; Monsalve, Conchita; Izquierdo, Laura; Martos, R.; Paredes, David; Beltrán, Joan; Oppenheimer, Federico; Alcaraz, Antonio

doi:10.1007/s00345-021-03912-1

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…However, this would be very challenging to do as there are many variables that can contribute to adverse patient outcomes and, overall, acute complications related to renal donations are low. 34 Another limitation of this study was that the total time required for the radiologist’s interpretation of the findings, pre- and post-template implementation, was not explored due to the retrospective nature of data analysis.…”

Section: Discussionmentioning

confidence: 99%

Standardized Reporting on the Preoperative CT Assessment of Potential Living Renal Transplant Donors: Can We Create a Universal Report Standard to Meet the Needs of Transplant Urologists?

et al. 2023

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Purpose: Determine whether standardized template reporting for the preoperative assessment of potential living renal transplant donors improves the comprehensiveness of radiology reports to meet the needs of urologists performing renal transplants. Methods: Urologist and radiologist stakeholders from renal transplant centers in our province ratified a standardized reporting template for evaluation of potential renal donors. Three centers (A, B, and C) were designated “intervention” groups. Center D was the control group, given employment of a site-specific standardized template prior to study commencement. Up to 100 consecutive CT scan reports per center, pre- and post-implementation of standardized reporting, were evaluated for reporting specific outcome measures. Results: At baseline, all intervention groups demonstrated poor reporting of urologist-desired outcome measures. Center A discussed 5/13 variables (38%), Center B discussed 6/13 variables (46%), and Center C only discussed 1/13 variables (8%) with ≥90% reliability. The control group exhibited consistent reporting, with 11/13 variables (85%) reported at ≥90% reliability. All institutions in the intervention group exhibited excellent compliance to structured reporting post-template implementation (Centers A = 95%, B = 100%, and C = 77%, respectively). Additionally, all intervention centers demonstrated a significant improvement in the comprehensiveness of reports post-template implementation, with statistically significant increases in the reporting of all variables under-reported at baseline ( P > .01). Conclusion: Standardized templates across our province for CT scans of potential renal donors promote completeness of reports. Radiologists can reliably provide our surgical colleagues with needed preoperative anatomy and incidental findings, helping to determine suitable transplant donors and reduce potential complications associated with organ retrieval.

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Section: Discussionmentioning

confidence: 99%

Standardized Reporting on the Preoperative CT Assessment of Potential Living Renal Transplant Donors: Can We Create a Universal Report Standard to Meet the Needs of Transplant Urologists?

et al. 2023

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“…Laparoscopic donor nephrectomy has become the standard of care in some centers. Nevertheless, left nephrectomy is more preferred for laparoscopic compared to open nephrectomy due to technical aspects [3]. At our center, laparoscopic donor nephrectomy has been exclusively performed on the left side [20].…”

Section: Discussionmentioning

confidence: 99%

“…This belief is based on the well-known information that hydronephrosis during pregnancy is more pronounced on the right side [2]. Nevertheless, such practice may create an extra-pressure on the transplant team especially in the context of the rapidly growing minimally invasive donor nephrectomy technique in which right nephrectomy is generally not preferred [3].…”

Section: Introductionmentioning

confidence: 99%

Live donor nephrectomy side: Is it implicated in urologic complications among lady donors during their post-donation pregnancies?

Donia

Elrefaie

Refaie

et al. 2022

Preprint

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Introduction: Our center policy is to promote right nephrectomy for pre-menopausal live donor ladies. This is based on the traditional belief that urologic complications of post-donation pregnancies would be more frequent among lady donors with a solitary right (compared to left) kidney. Studies that support or dismiss our policy are lacking. Therefore, we conducted this study. Methods: 100 ladies who had post-donation pregnancy were included. They underwent an updated clinical, laboratory and ultrasound assessment. They were classified into two groups: right and left nephrectomy groups. Both groups were compared relative to pre- and post-donation data as well as urologic complications during or after post-donation pregnancies and current kidney function. Results: Right nephrectomy was carried-out for 60 donors (60%). Post-donation acute pyelonephritis was not reported in either group. Unexpectedly, lower urinary tract infection during post-donation pregnancy occurred among 16.7% of ladies of the right nephrectomy group compared to 12.5% in the left nephrectomy group (p: non-significant). Conclusion: Despite that the endeavor to retrieve the right rather than the left kidney among lady donors could give them the benefit of doubt in regard to possible urological complications during their subsequent pregnancies, this policy is likely an overdoing practice. Larger-scale studies are needed.

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“…After adequate preparation and informed consent, a laparoscopic nephrectomy was performed as described previously [ 9 ]. After cold perfusion in the bench surgery, with the kidney graft still immersed in ice slush, the procedure began (Fig.…”

Section: Methodsmentioning

confidence: 99%

Living donor-gifted allograft lithiasis: surgical experience after bench surgery stone removal and follow-up

Sierra

Castillo²,

Carbonell

et al. 2023

Urolithiasis

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This study presents the surgical experience and long-term outcomes of living donor kidney transplantations involving asymptomatic kidney stones, using ex vivo flexible ureterorenoscopy (f-URS) during bench surgery for stone removal. Out of 1743 living kidney donors assessed between January 2012 and October 2022, 18 (1%) were diagnosed with urolithiasis. Among them, 12 donors were rejected, and 6 were accepted for kidney donation. Stone removal was successfully performed using f-URS during bench surgery, with no immediate complications or acute rejections observed. The study analyzed six living kidney transplants, of which 4 (67%) donors and three recipients were female, and 4 (67%) donors were blood-related to the recipient. The median age for donors and recipients was 57.5 and 51.5 years, respectively. The stones, primarily located in the lower calyx, had a median size of 6 mm. The median cold ischemia time during surgery was 41.6 min, and ex vivo f-URS ensured complete stone removal in all cases. After a median follow-up of 120 months, the remaining grafts were functioning well, and no urinary stone recurrence was observed in either the recipients or living donors. The findings suggest that bench f-URS is a safe approach for managing urinary stones in kidney grafts, providing good functional outcomes without stone recurrence in selected cases.

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Outcomes after 20 years of experience in minimally invasive living-donor nephrectomy

Cited by 8 publications

References 25 publications

Standardized Reporting on the Preoperative CT Assessment of Potential Living Renal Transplant Donors: Can We Create a Universal Report Standard to Meet the Needs of Transplant Urologists?

Standardized Reporting on the Preoperative CT Assessment of Potential Living Renal Transplant Donors: Can We Create a Universal Report Standard to Meet the Needs of Transplant Urologists?

Live donor nephrectomy side: Is it implicated in urologic complications among lady donors during their post-donation pregnancies?

Living donor-gifted allograft lithiasis: surgical experience after bench surgery stone removal and follow-up

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