title: [Living donor nephrectomy for kidney transplantation. Experience in the first two years].
abstract: OBJECTIVE
  Laparoscopic surgery offers potential advantages in terms of diminishment of postoperative pain, shorter hospital stay, faster convalescence, and better cosmetic results. These advantages may increase kidney donation, making donation be accepted by more candidates. We report our first 2 years' experience with laparoscopic donor nephrectomy
  
  
  METHODS
  Between March 2002 and February 2004 we performed 38 laparoscopic living donor nephrectomies for kidney transplantation. The technique of choice was the transperitoneal laparoscopic approach with four trocars, usually three of them from the start of the procedure--two 10-12 mm and one 5 mm--, and a 6.5 cm perumbilical midline incision for kidney retrieval at the end of the procedure.
  
  
  RESULTS
  Receptor and donor survivals were 100%. Graft survival was 97.6%. There was not any case of delayed graft function. Donor: Mean operative time was 161 minutes (115-260). Mean estimated blood loss was 270 ml (100-1200). Three patients required blood transfusions, 2 units of packed red blood cells each. Mean hospital stay was 5.1 days (3-11). Mean warm ischemia time was 3.2 min. (2-10). Conversion to open surgery was necessary in four cases. Receptor: there have been three significant complications requiring surgical repair: one case of low arterial flow, one vesico ureteral leak, and one midurethra stenosis. Initial renal function: mean serum creatinine at one month was 147mmol/l, with a trend to improve to 126 mmol/l at one year, which is considered optimum. First postoperative day mean serum creatinine was 192mmol/l and the nadir was on second postoperative day with a value of 152mmol/l.
  
  
  CONCLUSIONS
  We believe laparoscopic living donor nephrectomy is a real alternative to open surgery because it offers better recovery to the donor with the same capacity to preserve renal function in the receptor.
authors.affiliation: Servicio de Urología, Fundación Puigvert, Barcelona, España. aalcaraz@fundacio-puigvert.es
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
authors.forename: A
authors.initials: A
authors.lastname: Rosales
authors.forename: J
authors.initials: J
authors.lastname: Palou
authors.forename: J
authors.initials: J
authors.lastname: Caffaratti
authors.forename: M
authors.initials: M
authors.lastname: Montlleó
authors.forename: J
authors.initials: J
authors.lastname: Segarra
authors.forename: J
authors.initials: J
authors.lastname: Ponce de León
authors.forename: J
authors.initials: J
authors.lastname: Huguet
authors.forename: C
authors.initials: C
authors.lastname: Errando
authors.forename: J M
authors.initials: JM
authors.lastname: Díaz
authors.forename: L
authors.initials: L
authors.lastname: Guirado
authors.forename: H
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D010535:Laparoscopy; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D013997:Time Factors