A comparison of recipient renal outcomes with laparoscopic versus open live donor nephrectomy.
BACKGROUND
Laparoscopic donor nephrectomy (laparoNx) has the potential to increase living kidney donation rates by reducing the pain and suffering of the donor. However, renal function outcomes of a large series of recipients of laparoNx have not been studied.


METHODS
We retrospectively reviewed the records of 132 recipients of laparoNx done at our center between 3/96 and 11/97 and compared them to 99 recipients of kidneys procured by the open technique (openNx) done between 10/93 and 3/96.


RESULTS
Significantly more patients in the laparoNx group (25.2%) were taking tacrolimus within the first month than those in the openNx group (2.1%). Mean serum creatinine was higher in laparoNx compared with openNx at 1 week (2.8+/-0.3 and 1.8+/-0.2 mg/dl, respectively; P=0.005) and at 1 month (2.0+/-0.1 and 1.6+/-0.1 mg/dl, P=0.05) after transplant. However, by 3 and 6 months, the mean serum creatinine was similar in the two groups (1.7+/-0.1 versus 1.5+/-0.05 mg/dl, and 1.7+/-0.1 versus 1.7+/-0.1, respectively). By 1 year posttransplant, the mean serum creatinine for laparoNx was actually less than that for openNx (1.4+/-0.1 and 1.7+/-0.1 mg/dl, P=0.03). Although patients in the laparoNx compared to the openNx group were more likely to have delayed graft function (7.6 versus 2.0%) and ureteral complications (4.5 versus 1.0%), the rate of other complications, as well as hospital length of stay, patient and graft survival rates were similar in the two groups.


CONCLUSIONS
Although laparoNx allografts have slower initial function compared with openNx, there was no significant difference in longer term renal function.
Nogueira
J M
JM
Department of Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
Cangro
C B
CB
Fink
J C
JC
Schweitzer
E
E
Wiland
A
A
Klassen
D K
DK
Gardner
J
J
Flowers
J
J
Jacobs
S
S
Cho
E
E
Philosophe
B
B
Bartlett
S T
ST
Weir
M R
MR
D000328:Adult; D003404:Creatinine / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy; D019520:Living Donors; D009392:Nephrectomy; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D003404:Creatinine; D016559:Tacrolimus