Hand-assisted laparoscopic donor nephrectomy for pediatric kidney allograft recipients.
Laparoscopic donor nephrectomy (LDN) is the method of choice for procuring kidneys from living donors at many transplant centers. The aim of this study was to assess the feasibility as well as outcome of LDN in pediatric recipients. Twenty-two pediatric patients, 18-yr old or younger received kidneys procured by a hand-assisted LDN technique. The mean operative time was no different (p = 0.9) and the mean length of stay was more than 1 day shorter in the LDN group (p = 0.0001) compared with the 13 pediatric patients who received kidneys by standard open nephrectomy. Body mass index (BMI), number of donor kidney vessels, or laterality of the kidney did not impact the donor operation or outcome. Actuarial 1-yr patient survival was 100% and allograft survival was 95%, which are equivalent to registry data. There were no donor mortalities and there were five morbidities. None required hospitalization. There were no conversions from LDN to open nephrectomy. One kidney was lost because of overwhelming infection necessitating withdrawal of immunosuppression. In conclusion, hand-assisted LDN is a safe method of procuring kidneys from potential donors with no significant negative outcomes to the pediatric recipients.
Kim
Dean Y
DY
Department of Surgery, Division of Transplantation Surgery, William J. von Liebig Transplant Center, Mayo Medical School, Foundation and Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Stegall
Mark D
MD
Prieto
Mikel
M
Chow
George K
GK
Bohorquez
Humberto E
HE
Covarrubias
Marco A
MA
Heimbach
Julie K
JK
Morgenstern
Bruce Z
BZ
Gloor
James M
JM
Milliner
Dawn S
DS
Weckwerth
Jody A
JA
Weis
Karla D
KD
Ishitani
Michael B
MB
D000293:Adolescent; D000328:Adult; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D014184:Transplantation, Homologous / Q000379:methods