The Auckland experience with laparoscopic donor nephrectomy.
OBJECTIVE
To examine the initial experience of laparoscopic donor nephrectomy (LDN) in New Zealand and compare it with open donor nephrectomy (ODN).


METHODS
All LDNs performed between June 2000 and June 2002 were reviewed. An equal number of ODNs were reviewed. Data were also collected on the recipients of the grafts. Key clinical data were prospectively collected; remaining data were collected by retrospectively reviewing patient charts. Auckland Hospital databases were accessed for costing analysis.


RESULTS
Thirty five cases of each procedure had been performed. There has been 100% LDN graft survival. There was no significant difference in graft function (serum creatinine) at one and 12 months (p = 0.25 and 0.35) between the two groups. There was no significant difference in donor morbidity (26% vs 31%, p = 0.59). LDN resulted in a shorter hospital stay (3 vs 6.5 days, p <0.0001) and convalescence period (3 vs 6 weeks, p <0.0001). LDN was significantly more expensive (13 357 dollars vs 6713 dollars, p <0.0001).


CONCLUSIONS
LDN in the New Zealand setting provides effective grafts for renal transplant recipients and is safe for the donor. Advantages for the donor are a shorter hospital stay and convalescence period. The major disadvantage of LDN is its higher cost compared with ODN.
Muthu
Carl
C
Auckland Hospital, Auckland, New Zealand. carlm@xtra.co.nz
McCall
John
J
Windsor
John
J
Harman
Richard
R
Dittmer
Ian
I
Smith
Pat
P
Munn
Stephen
S
D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D006085:Graft Survival; D006801:Humans; D010535:Laparoscopy / Q000191:economics; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D009520:New Zealand; D011446:Prospective Studies; D012189:Retrospective Studies; D014019:Tissue Donors