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Laparoscopic Live Donor Nephrectomy: The Future Gold Standard?

Vikram H N , Vikram H N

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Urology, Nephrology and Andrology International 6(1):p 7-12, January-June 2021. | DOI: http://dx.doi.org/10.21088/unai.2456-5016.6121.1

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Vikram H N/ Laparoscopic Live Donor Nephrectomy –The Future Gold Standard?./ Urology, Nephrology and Andrology International. 2021;6(1):7-12.

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Abstract

End stage renal disease (ESRD) has been a long-standing challenge for the community. Renal transplantation being the mainstay treatment reaches only about 5% of the patients due to supply demand mismatch. Open donor nephrectomy (ODN) is the common method of renal allograft harvest. Since it is associated with significant morbidity, the less invasive laparoscopic donor nephrectomy (LDN) is gaining importance. Objectives: This study attempts to compare a group of donors undergoing LDN to those undergoing ODN in terms of factors like operating time, blood loss, conversion rates, hospital stay, complications, post-operative donor renal function along with assessment of graft function. Methods: A prospective non randomized study was conducted on 58 live donors who consented to donate kidney for renal transplantation at Meenakshi Mission Hospital and Research Centre, India. They were compared for intra-operative variables, postoperative complications, post-operative donor function and recipient renal function thereby assessing the graft function. The donors and recipients were followed for a period of 1 year to assess their renal function, occurrence of any new co-morbid conditions, recipients’ graft function. Continuous variables were analyzed using Student’s t-test while categorical variables were compared using the chi square test. ‘a’ value was set at 0.05. Results: Of the 58 patients, LDN was done in 28 patients with two undergoing conversion. The mean operation duration and warm ischemia time for LDN and ODN groups were similar. The length of hospital stay was significantly shorter in LDN group. There were no major complications nor was there any significant differences in the post-operative donor/recipient renal function as well. Conclusion: LDN can evidently be performed with less morbidity, better donor satisfaction and equivalent initial graft function.

Keywords: Open donor nephrectomy; Laparoscopic donor nephrectomy; Kidney transplantation; End stage renal disease; Donor outcome transplantation; End stage renal disease; Donor outcome.

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Vikram H N/ Laparoscopic Live Donor Nephrectomy –The Future Gold Standard?./ Urology, Nephrology and Andrology International. 2021;6(1):7-12.

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DOI: http://dx.doi.org/10.21088/unai.2456-5016.6121.1

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