Laparoscopic assisted live donor nephrectomy - A comparison with the open approach

Lloyd E. Ratner, Louis R. Kavoussi, Myrna Sroka, Janet Hiller, Rebecca Weber, Peter G. Schulam, Robert Montgomery

Research output: Contribution to journalArticle

Abstract

Live donor renal transplantation provides significant advantages when compared with cadaveric donor renal transplantation in terms of improved patient and graft survival, a lower incidence of delayed function, and a shorter waiting time. Yet despite these advantages, live donors continue to be an under utilized source of kidneys for transplantation. Disincentives to live donation include the length of hospitalization, postoperative pain, cosmetic concerns, and the prolonged convalescence associated with the donor operation. In many instances minimally invasive video-assisted techniques have proven more efficacious than standard open procedures in terms of patient discomfort, length of hospital stay, cost, and length of time until the patient can return to full activity. Laparoscopic live donor nephrectomies are being performed at our institution in an attempt to make live donation more attractive to the potential donor. The purpose of this study was to retrospectively review the results of laparoscopic live donor nephrectomy (LapNx) and to compare them with those obtained using the standard open approach (OpenNx). Ten consecutive LapNx were performed from February 1995 through April 1996. The control group consisted of the 20 consecutive OpenNx performed at the same institution from January 1991 through January 1995 immediately before the initiation of the LapNx program. Live donors were considered candidates for LapNx if they possessed at least one kidney with normal renal anatomy with single renal vessels and a single ureter. LapNx was safely performed in all cases. No patients required open conversion or blood transfusions. The allograft warm ischemic time for the laparoscopic cases was 4.2±1.3 min. All kidneys harvested laparoscopically produced urine on the table immediately upon revascularization. Presently nine of the ten recipients have functioning allografts. At three months posttransplant the calculated recipient creatinine clearances were 67.0±11.5 ml/min and 64.8±21.4 ml/min for the LapNx and OpenNx groups, respectively (P=NS). The LapNx donors had a significantly decreased estimated blood loss, shorter time until resumption of oral intake, decreased postoperative pain (in terms of decreased analgesic requirements), shorter hospitalization, and a shorter interval until the resumption of full activities (P

Original languageEnglish (US)
Pages (from-to)229-233
Number of pages5
JournalTransplantation
Volume63
Issue number2
DOIs
StatePublished - Jan 27 1997

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Nephrectomy
Tissue Donors
Kidney Transplantation
Kidney
Postoperative Pain
Allografts
Length of Stay
Hospitalization
Warm Ischemia
Hospital Costs
Graft Survival
Ureter
Cosmetics
Blood Transfusion
Analgesics
Motivation
Creatinine
Anatomy
Urine
Control Groups

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Ratner, L. E., Kavoussi, L. R., Sroka, M., Hiller, J., Weber, R., Schulam, P. G., & Montgomery, R. (1997). Laparoscopic assisted live donor nephrectomy - A comparison with the open approach. Transplantation, 63(2), 229-233. https://doi.org/10.1097/00007890-199701270-00009

Laparoscopic assisted live donor nephrectomy - A comparison with the open approach. / Ratner, Lloyd E.; Kavoussi, Louis R.; Sroka, Myrna; Hiller, Janet; Weber, Rebecca; Schulam, Peter G.; Montgomery, Robert.

In: Transplantation, Vol. 63, No. 2, 27.01.1997, p. 229-233.

Research output: Contribution to journalArticle

Ratner, LE, Kavoussi, LR, Sroka, M, Hiller, J, Weber, R, Schulam, PG & Montgomery, R 1997, 'Laparoscopic assisted live donor nephrectomy - A comparison with the open approach', Transplantation, vol. 63, no. 2, pp. 229-233. https://doi.org/10.1097/00007890-199701270-00009
Ratner LE, Kavoussi LR, Sroka M, Hiller J, Weber R, Schulam PG et al. Laparoscopic assisted live donor nephrectomy - A comparison with the open approach. Transplantation. 1997 Jan 27;63(2):229-233. https://doi.org/10.1097/00007890-199701270-00009
Ratner, Lloyd E. ; Kavoussi, Louis R. ; Sroka, Myrna ; Hiller, Janet ; Weber, Rebecca ; Schulam, Peter G. ; Montgomery, Robert. / Laparoscopic assisted live donor nephrectomy - A comparison with the open approach. In: Transplantation. 1997 ; Vol. 63, No. 2. pp. 229-233.
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