Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Asian J Endosc Surg. 2024 Jul;17(3):e13355. doi: 10.1111/ases.13355.
The left kidney is often preferred for living donor kidney transplantation because of its anatomical advantages. However, the right kidney may be procured due to donor conditions. Few studies have assessed the safety and graft outcome of right retroperitoneal laparoscopic donor nephrectomy (RDN). This study aimed to compare the outcomes between right and left RDN with respect to donor outcome and the graft function of recipients.
This retrospective study included 230 consecutive living donor kidney transplants performed at our institution between May 2019 and March 2023. We reviewed the outcomes of kidney transplant in the right and left kidneys after RDN.
A total of 230 living donor kidney transplants were performed, with 32 donors receiving right RDN (right RDN group) and 198 donors receiving left RDN (left RDN group). The renal veins and ureters were significantly shorter in the right RDN group than in the left RDN group (both p < .001). Donor operation and warm ischemia time were significantly longer in the right RDN group than in the left RDN group (p = .012 and p < .001, respectively). None of the groups exhibited any cases of delayed graft function owing to donor-related reasons. Perioperative changes in the estimated glomerular filtration rate of recipients and death-censored graft survival were not significantly different between the two groups.
In RDN, the outcomes of right donor nephrectomy were comparable to those of left donor nephrectomy in terms of donor safety and recipient renal function.
由于解剖学优势,左肾通常是活体供肾移植的首选。但是,由于供者的情况,可能会获取右肾。很少有研究评估右后腹腔镜供肾切取术(RDN)的安全性和移植物结局。本研究旨在比较右肾和左肾 RDN 在供者结局和受者移植物功能方面的结果。
这是一项回顾性研究,纳入了 2019 年 5 月至 2023 年 3 月在我院进行的 230 例连续活体供肾移植患者。我们回顾了 RDN 后右肾和左肾移植的结果。
共进行了 230 例活体供肾移植,其中 32 例供者接受右 RDN(右 RDN 组),198 例供者接受左 RDN(左 RDN 组)。右 RDN 组的肾静脉和输尿管明显短于左 RDN 组(均 P <.001)。右 RDN 组的供者手术和热缺血时间明显长于左 RDN 组(分别为 P =.012 和 P <.001)。两组均未因供者相关原因出现延迟移植物功能。受者的估算肾小球滤过率和死亡风险校正移植物存活率在两组间的围手术期变化无显著差异。
在 RDN 中,右供肾切取术的结果在供者安全性和受者肾功能方面与左供肾切取术相当。