Are live kidney donors at risk?
OBJECTIVE
To share experience of live donor nephrectomy (including intraoperative variables, morbidity and ethical aspects) and to give an overview of surgical technique being practiced.


METHODS
A department-based prospective study.


METHODS
Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore, (September 1998 to March 2002). SUBJECTS AND METHODS During the study period, 58 patients had undergone live donor nephrectomy through 11th rib bed flank incision. Evaluation of donors comprised of counseling, history taking, physical examination and laboratory testing and radiological studies to document bilaterally functioning kidneys. Medical ailments, immunological incompatibility and inability to make a valid consent were contraindications for kidney donation.


RESULTS
Majority of the donors (58.5%) were 31-50 years old and 70.6% were first degree relatives. Left sided kidney was taken in 96.5% cases. Mean operative time was 145 minutes. Mean renal warm ischemia time from cross clamping of renal vessels to cold perfusion on the bench was 1.5 minutes per operation. Operative complications encountered were injury to lumbar veins in 5.1 % cases, slipping of satinsky clamp on vena cava stump in 1.7 % and accidental pleural damage in 5.1 % cases. Postoperative morbid complications found were urinary retention in 6.4% cases, epididymo-orchitis in 1.7 %, prolonged lymph drain in 3.4%, stitch infection in 1.7 % and prolonged wound discomfort in 5.1 % patients.


CONCLUSIONS
Open live donor nephrectomy appears to be safe procedure for harvesting kidney. Related or emotionally related donors must be the choice in all cases. Non-related donors may be entertained in selected cases despite the probability of organ vending in our society.
Kamran
Tahir
T
Department of Urology, Lahore General Hospital/PGMI, Lahore. tkk@brain.net.pk
Zaheer
Kashif
K
Hussain
Syed Waqar
SW
Zahid
Khalid Hussain
KH
Akhtar
Mohammad Saleem
MS
D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007431:Intraoperative Complications; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends*; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors