Perioperative Events and Complications in Minimally Invasive Live Donor Nephrectomy

Kortram, Kirsten; IJzermans, Jan N. M.; Dor, Frank J. M. F.

doi:10.1097/tp.0000000000001327

Cited by 71 publications

(71 citation statements)

References 185 publications

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“…19 A systematic review and meta-analysis found postoperative complications after minimally invasive nephrectomy occurred in 7.3% of living donors. 20 Also, in a recent national study of nearly 15,000 United States donors, 16.8% of donors experienced a perioperative complication. 21 Moreover, a questionnaire study of donors 3 months after their operation found that 18.5% rated their overall health as "somewhat worse" than before.…”

Section: Disincentive 4: Risk Of Dying From Kidney Removalmentioning

confidence: 99%

Removing Disincentives to Kidney Donation: A Quantitative Analysis

McCormick

Held

Chertow

et al. 2019

JASN

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Section: Disincentive 4: Risk Of Dying From Kidney Removalmentioning

confidence: 99%

Removing Disincentives to Kidney Donation: A Quantitative Analysis

McCormick

Held

Chertow

et al. 2019

JASN

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“…The currently available techniques for minimally invasive live donor nephrectomy are safe and associated with low complication rates, and minimal risk of mortality. [41]…”

Section: Discussionmentioning

confidence: 99%

Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

et al. 2017

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BackgroundThe transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals.MethodsAn online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide.Results331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging.ConclusionsRemarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based.

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“…OPTN data indicates that there were only five donation-related deaths within a year of donation in live donors in 2012 [2]. A recent meta-analysis reported that the mortality rate after live donor nephrectomy was 0.01% [27]. However, it remains unclear what percentage of previously obese individuals who undergo BS followed by live-donor nephrectomy will subsequently develop renal failure.…”

Section: Transplantation After Donor Bariatric Surgerymentioning

confidence: 99%

Bariatric surgery for obese live kidney donors: an analysis of risks and benefits

Brooks¹,

Mitro²,

DeLeonibus³

et al. 2017

Integr Obesity Diabetes

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Background: Obesity can be a barrier to live donor selection and there are reports of obese live kidney donors (OLKDs) undergoing bariatric surgery prior to donation. While this practice has potential promise, the risks associated with it are unclear. Thus, our aim was to evaluate the advantages and disadvantages of this practice.Design: Risks and benefits were ascertained from the literature. Analysis of costs and benefits was performed to provide objective data for each scenario.Results: Live kidney donation is associated with superior outcomes compared to deceased donation. However, live donors are at risk of complications that could be exacerbated by obesity. Higher donor body mass index (BMI) has been associated with inferior recipient outcomes. Bariatric surgery (BS) results in decreased mortality and can induce sustained weight loss. Our cost-benefit analysis revealed a benefit-to-cost ratio of 3.64 for BS prior to live donation by OLKDs. We found ratios of 3.19 and 0.97 for live donation with an obese donor and a deceased donor, respectively. Conclusions:Our results suggest that BS for an OLKD has the potential to increase the number of live donors and improve outcomes. However, more data is required; thus we recommend a registry of patients who have undergone both procedures.

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Perioperative Events and Complications in Minimally Invasive Live Donor Nephrectomy

Abstract: The used techniques for minimally invasive live donor nephrectomy are safe and associated with low complication rates and minimal risk of mortality. These data may be helpful to develop a standardized, donor-tailored informed consent procedure for live donor nephrectomy.

Cited by 71 publications

References 185 publications

Removing Disincentives to Kidney Donation: A Quantitative Analysis

Removing Disincentives to Kidney Donation: A Quantitative Analysis

Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

Bariatric surgery for obese live kidney donors: an analysis of risks and benefits

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