Prospective, nonrandomized comparison between right- and left-sided hand-assisted laparoscopic donor nephrectomy

Transplant Proc. Jan-Feb 2011;43(1):353-6. doi: 10.1016/j.transproceed.2010.12.021.

Abstract

Background: Despite technical improvements, laparoscopic living donor right nephrectomy can be associated with difficulties to obtain a sufficient lengths of right renal vessels. We report our experience with right-sided, hand-assisted, laparoscopic donor nephrectomy (HALDN).

Patients and methods: During a 7-year period (2003-2010), right HALDN was performed on 51 and left HALDN on 40 living kidney donors. We prospectively collected perioperative outcome data in donors and recipients including graft function and calculated 1-year graft survival according to the Kaplan-Meier-method.

Results: There were no conversions. The mean procedure time was 123 minutes versus 135 minutes for left HALDN (P = .09). Mean blood loss was 92 mL versus 101 mL in left HALDN (P = .09). There was no renal artery or vein thrombosis. The mean warm ischemia time was 47 seconds versus 41 seconds in left HALDN (P = .21). Hospital discharge was on an average at 3.4 days postoperatively. Delayed graft function occurred in two recipients: one in the left group and the other in the right group. Further, no significant difference in serum creatinine values was seen between the groups at 1 year after the transplantation. One-year graft survival rate was 97.5% in the left versus 98.1% in the right group.

Conclusion: Right HALDN is as safe and feasible as left HALDN. Hand-assistance results in a convenient length of right renal vessels without an increased incidence of vascular thrombosis.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Female
  • Functional Laterality*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Nephrectomy / methods*
  • Prospective Studies