Afaneh C, Ramasamy R, Aull MJ, Leeser DB, Sosa RE, Kapur S and Del Pizzo JJ
Background: Laparoscopic donor nephrectomy represents a significant source of allografts to patients with endstage renal disease. Given the increasing wait-list and limited number of deceased donors, utilization of the right kidney is necessary to maximize the donor pool.
Materials: We retrospectively reviewed 122 right-sided kidney donors; 73 hand-assisted laparoscopic donor nephrectomies (R-HAL-DN), 36 standard laparoscopic donor nephrectomies (R-LAP-DN), and 13 laparoendoscopic single site donor nephrectomies (R-LESS-DN). We compared these groups to matched left donors and each other, analyzing various parameters including operative times, warm ischemia time (WIT), estimated blood loss (EBL), incision length, length of stay (LOS), convalescence data and complications.
Results: Right and left donors demonstrated no difference in analysis parameters in all 3 procurement techniques. When comparing all right donors total operative time and allograft extraction time were lowest in the R-LAP-DN group (p=0.003 & p=0.04, respectively). The R-LESS-DN group had the lowest EBL (p=0.06) and shortest incision length (p<0.0001). The LOS was shortest in the R-LAP-DN group (p=0.03). WIT, donor convalescence, and recipient allograft function were similar in all 3 groups.
Conclusion: Our data demonstrates the safety and reproducibility of procuring the right kidney. Donor safety and allograft function have continued through evolution of the technique.
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