The Safety and Efficacy of Laparoscopic Live Donor Nephrectomy: A Systematic Review1

Abstract

The ASERNIP-S Review Group concluded that the evidence-base for laparoscopic live donor nephrectomy was inadequate to make a safety and efficacy recommendation. Clinical and research recommendations were developed regarding the introduction and current practice of this procedure in Australia.

Laparoscopic (vs. Open) Live Donor Nephrectomy: A UNOS Database Analysis of Early Graft Function and Survival

“…But to date, no study has shown a significant difference in rejection rate and long-term survival when comparing laparoscopic to open kidney grafts (2,7,(10)(11)(12)(13)(14)(19)(20)(21)(22). In our analysis, the procurement mode did not affect acute rejection incidence and long-term graft survival either.…”

“…Multiple studies have shown that laparoscopic nephrectomy is considerably gentler for the donor, because it is associated with less postoperative pain, a shorter length of hospital stay, improved cosmesis, and faster return to work and activities of daily living (2). Some investigators have even suggested that the availability of the minimally invasive procurement mode has significantly contributed to the recent increase of live kidney donations in the United States (3)(4)(5).…”

Laparoscopic Live Donor Nephrectomy: A Risk Factor for Delayed Function and Rejection in Pediatric Kidney Recipients? A UNOS Analysis

“…The recently observed increase in live kidney donations in the United States is thought to be, at least in part, the result of the introduction of laparoscopic donor nephrectomy, which was shown to result in a shorter length of hospital stay, less post-operative pain, improved cosmesis and more rapid return to work and to normal activities of daily life for the kidney donors (20)(21)(22)(23)(24). Hence, it is not surprising that the laparoscopic procurement mode has rapidly become the preferred approach to the live kidney donor for transplantation of adult recipients (2).…”

Surgical Advances in Laparoscopic Donor Nephrectomy

“…Various studies and reviews have demonstrated a complication rate ranging from 0% to 38% using the open procurement approach and 0% to 30% with the conventional laparoscopic approach [22,23]. More recent studies have reported complications of less than 10% in conventional laparoscopic donor nephrectomy [24,25].…”