title: Hand-assisted laparoscopic donor nephrectomy for pediatric kidney allograft recipients.
abstract: 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.
authors.affiliation: 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.
authors.forename: Dean Y
authors.initials: DY
authors.lastname: Kim
authors.forename: Mark D
authors.initials: MD
authors.lastname: Stegall
authors.forename: Mikel
authors.initials: M
authors.lastname: Prieto
authors.forename: George K
authors.initials: GK
authors.lastname: Chow
authors.forename: Humberto E
authors.initials: HE
authors.lastname: Bohorquez
authors.forename: Marco A
authors.initials: MA
authors.lastname: Covarrubias
authors.forename: Julie K
authors.initials: JK
authors.lastname: Heimbach
authors.forename: Bruce Z
authors.initials: BZ
authors.lastname: Morgenstern
authors.forename: James M
authors.initials: JM
authors.lastname: Gloor
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Milliner
authors.forename: Jody A
authors.initials: JA
authors.lastname: Weckwerth
authors.forename: Karla D
authors.initials: KD
authors.lastname: Weis
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ishitani
mesh_terms: 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