An audit over 2 years' practice of open and laparoscopic live-donor nephrectomy at renal transplant centres in the UK and Ireland.
OBJECTIVE
To collate information on the practice of live-donor nephrectomy and compare this with the published British Transplantation Society (BTS) guidelines for best practice, using two questionnaires sent to all renal transplant centres in the UK and Ireland to cover practice for the years 2000 and 2002.


METHODS
A postal questionnaire was sent to all surgical kidney transplant consultants in the UK and Ireland, including questions on the practice of live-donor nephrectomy in the year 2000 (the questionnaire was sent in 2001) and 2002 (questionnaire sent in 2003).


RESULTS
All 28 centres responded fully for both years; 27 centres used live kidney donation in 2000, decreasing to 24 in 2002. Consultants reported 356 operations in 2000, representing 19% of all kidney transplants, and 403 in 2002, representing 23% of all kidney transplants. Three centres offered laparoscopic donor nephrectomy in 2000, and five did so in 2002. Most centres organize donor and recipient operations synchronously, and most have a consultant anaesthetist present for the donor procedure. There were variations in the use of analgesia and thromboprophylaxis, and in donor follow-up.


CONCLUSIONS
There is widespread application of live-donor nephrectomy in the UK but BTS guidelines are not closely followed. Minimal access donor nephrectomy is offered at a few centres but many have plans to introduce this into their practice.
Brook
N R
NR
Division of Transplantation, The University Department of Surgery, Leicester General Hospital, Leicester, UK. nicholasbrook@fastmail.fm
Nicholson
M L
ML
D000700:Analgesics / Q000627:therapeutic use; D000777:Anesthetics / Q000627:therapeutic use; D002983:Clinical Competence / Q000592:standards; D019538:Health Care Surveys; D006801:Humans; D007494:Ireland; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008485:Medical Audit; D009392:Nephrectomy / Q000379:methods*; D013927:Thrombosis / Q000517:prevention & control; D006113:United Kingdom
D000700:Analgesics; D000777:Anesthetics