Laparoscopic live-donor nephrectomy.
Laparoscopic nephrectomy with ablative intent has been performed clinically. The current study aimed to determine whether a physiologically and anatomically intact kidney suitable for transplantation could be harvested laparoscopically. Three weeks after an ablative laparoscopic right nephrectomy, 15 pigs were divided into two groups: the study group (n = 10) underwent a laparoscopic live-donor left nephrectomy of the solitary kidney and conventional autotransplantation; the control group (n = 5) underwent an open live-donor left nephrectomy of the solitary kidney and conventional autotransplantation. All study kidneys underwent laparoscopic in situ hypothermic perfusion. The mean length of the left renal artery and vein were similar in the study and control groups: 3.1 cm and 3.4 cm, respectively, in the study group compared with 2.5 cm and 3.8 cm, respectively, in the control group (P = 0.5). No intraoperative renal vascular injuries or postoperative ureteral complications were noted in either group. Renal histopathologic examination immediately after live-donor nephrectomy and at 1 month post-transplant showed similar findings in the two groups. The mean serum creatinine at 7 and 30 days postoperatively was not significantly different: 2.1 mg/dL and 1.6 mg/dL, respectively, in the study group and 1.7 mg/dL, and 1.4 mg/dL, respectively, in the control group (P = 0.4). We conclude that laparoscopic live-donor nephrectomy can be performed safely and reproducibly in the porcine model.
Gill
I S
IS
Division of Urology, University of Kentucky Albert Chandler Medical Center, Lexington.
Carbone
J M
JM
Clayman
R V
RV
Fadden
P A
PA
Stone
M A
MA
Lucas
B A
BA
McRoberts
J W
JW
D000255:Adenosine Triphosphate / Q000097:blood; D000818:Animals; D005260:Female; D007036:Hypothermia, Induced; D007668:Kidney / Q000502:physiology; D016030:Kidney Transplantation; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*; D010725:Phosphocreatine / Q000097:blood; D011184:Postoperative Period; D013552:Swine; D014019:Tissue Donors; D014182:Transplantation, Autologous
D010725:Phosphocreatine; D000255:Adenosine Triphosphate