title: Concomitant surgery with laparoscopic live donor nephrectomy.
abstract: Routine live donor evaluations reveal unexpected silent pathologies. Herein, we describe our experience treating such pathologies at the time of laparoscopic donor nephrectomy. We have not encountered any previous reports of such an approach. We prospectively collected data on 321 donors. Concomitant surgeries at the time of procurement included two laparoscopic adrenalectomies, one colposuspension, one laparoscopic cholecystectomy, and one liver biopsy. Mean operative time was 321 min (range 230-380), with a mean blood loss of 280 mL (range 150-500). No blood transfusions were required. The left kidney was procured in four cases. The right kidney was obtained on one occasion. Mean hospital stay was 3 days (median 3, range 2-4). No short- or long-term complications have been identified. Mean follow-up time was 2.63 years (median 2.76, range 2.23-2.99). Four of the five kidney recipients were first-time transplants who had not yet started dialysis. Simultaneous surgical interventions at the time of laparoscopic live kidney donation are safe and can be undertaken in selected cases. This practice is beneficial to both the donor and the recipient, and is likely to become more commonplace with changing practice patterns involving donor evaluation and management.
authors.affiliation: Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD, USA. emolmem1@jhmi.edu
authors.forename: Ernesto P
authors.initials: EP
authors.lastname: Molmenti
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.forename: Robert A
authors.initials: RA
authors.lastname: Montgomery
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Su
authors.forename: Edward
authors.initials: E
authors.lastname: Kraus
authors.forename: Matthew
authors.initials: M
authors.lastname: Cooper
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Sonnenday
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Klein
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
authors.forename: Lloyd E
authors.initials: LE
authors.lastname: Ratner
mesh_terms: D000236:Adenoma / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000328:Adult; D002764:Cholecystitis / Q000150:complications / Q000601:surgery; D002769:Cholelithiasis / Q000150:complications / Q000601:surgery; D005260:Female; D006432:Hemochromatosis / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery; D044465:White People