Early and late graft function after laparoscopic hand-assisted donor nephrectomy for living kidney transplantation: comparison with open donor nephrectomy.

BACKGROUND AND PURPOSE

Laparoscopic donor nephrectomy has become the procedure of choice for living kidney transplantation in many centers. We report on our experience with laparoscopic hand-assisted donor nephrectomy, in particular concerning graft function compared with open donor nephrectomy.

MATERIALS AND METHODS

Between 1995 and March 2007, 72 patients with end-stage renal disease have received kidney transplantation from living donors. Open living donor nephrectomy (ODN) was performed in 35 donors, whereas 37 donors had undergone laparoscopic hand-assisted nephrectomy (HALDN). Immediate graft function, serum creatinine and serum cystatin C 1 year after the transplantation were evaluated.

RESULTS

Median operative time was 138 min (113-180 min) in the HALDN group and 112 min (91-162 min) in the ODN group (p < 0.05). Warm ischemia time was 87 s (63-150 s) in the HALDN and 81 s (56-123 s) in the ODN groups, respectively (p = 0.13). Both the rate of primary graft function as well as kidney graft function parameters serum creatinine and serum cystatin C 1 year after transplantation showed no statistically significant difference between the two groups of patients.

CONCLUSIONS

Laparoscopic hand-assisted donor nephrectomy is safe and has no negative impact on the transplanted graft function when compared with open donor nephrectomy.