Faculty Collaboration Database

Complications after a 5-year experience with laparoscopic donor nephrectomy: the Indiana University experience. Surg Endosc 2007 May;21(5):724-8

Date

03/06/2007

Pubmed ID

17334861

DOI

10.1007/s00464-006-9176-6

Scopus ID

2-s2.0-34247608822 (requires institutional sign-in at Scopus site)   51 Citations

Abstract

BACKGROUND: Laparoscopic donor nephrectomy (LDN) is becoming the standard of care for living donor nephrectomy. However, questions have been raised about the safety of LDN for the donor and about the potentially increased rates for ureteral complications experienced by the recipient. In this report, the authors review their 5-year experience with 253 living laparoscopic donor nephrectomies.

METHODS: A retrospective chart review was performed for 253 laparoscopic live donors. Graft function and survival were compared using recipient postoperative creatinine values up to 12 months.

RESULTS: The overall rate of complications in the investigated series was 10.3%. There were seven intraoperative complications (2.8%), three of which required open conversion. There were 19 postoperative complications (7.5%), three of which required reexploration for bleeding. The majority of complications were minor including 62% grade 1, 8% grade 2, 31% grade 3, and no grade 4 or 5 complications. There were no intraoperative complications in the right-sided donor group. There was a 5% complication rate for patients with a body mass index (BMI) exceeding 25. The findings showed that 11.2% of the recipients had slow graft function, and 4.4% had delayed graft function. Less than 1% of the recipients experienced ureteral stricture requiring permanent stent placement or reoperation. Overall, there was a 2% graft loss rate.

CONCLUSIONS: The findings show a low rate of intraoperative and postoperative complications, most of which were minor complications. There was an increase in operative time and hospital stay in the right-sided group, but no increase in complication rate. There was no significant difference in outcome or complication rate for the overweight patients.

Author List

Sundaram CP, Martin GL, Guise A, Bernie J, Bargman V, Milgrom M, Shalhav A, Govani M, Goggins W

Author

Amy Guise MD Associate Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Body Mass Index
Delayed Graft Function
Graft Survival
Hemorrhage
Humans
Incidence
Intraoperative Complications
Kidney
Kidney Transplantation
Laparoscopy
Living Donors
Middle Aged
Nephrectomy
Postoperative Complications
Reoperation
Retrospective Studies
Stents
Time Factors
Ureteral Obstruction