Laparoscopic kidney donation from patients older than 60 years.
BACKGROUND
The current study seeks to determine if the efficacy and safety of laparoscopic donor nephrectomy holds true when performed in patients older than 60 years of age.


METHODS
Medical records of 42 renal donors older than 60 years were reviewed compared with younger controls carefully matched for gender, race, nephrectomy side, auxiliary recipient procedures, and date of surgery.


RESULTS
Preoperative baseline serum creatinine was identical in both groups (0.9 +/- 0.2 mg/dL) although controls had a slightly higher (NS) creatinine clearance (106.9 +/- 19.1 versus 100.0 +/- 35.5 mL/m). Operatively, there was no substantial difference between groups in operative time, warm ischemia time, estimated blood loss, number or size of ports used, and length of incision needed for removal of kidney. Intraoperative and postoperative complication rates were also equivalent between old and young donors. Postnephrectomy serum creatinine was identical. There was no increased length of hospitalization for older donors and they tended to require less morphine sulfate patient-controlled anesthesia. Recipient renal function was slightly better in the younger kidneys early and the difference became statistically significant at 6 to 12 months, but the magnitude of the improvement is not clinically important.


CONCLUSIONS
Laparoscopic donor nephrectomy may be performed safely in patients older than 60 years of age. There was no increase in complication rates or length of hospital stay. Older donors did not have a greater increase in serum creatinine after donation compared with donors younger than 40 years of age, nor did recipients of these older kidneys have clinically significantly higher serum creatinine than recipients of kidneys from donors less than 40 years old.
Jacobs
Stephen C
SC
Department of Surgery, Division of Urology, University of Maryland School of Medicine, Baltimore, MD, USA.
Ramey
J Robert
JR
Sklar
Geoffrey N
GN
Bartlett
Stephen T
ST
D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007668:Kidney / Q000502:physiology; D016030:Kidney Transplantation / Q000502:physiology; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000453:epidemiology; D012449:Safety
D003404:Creatinine