Laparoscopic live donor nephrectomy has equivalent early and late renal function outcomes compared with open donor nephrectomy.
OBJECTIVE
To assess the patterns of early functional recovery and long-term function in laparoscopic and open procured live donor nephrectomy (LDN) kidneys, highlighting the radionuclide scan as an additional tool for assessment, because of concerns regarding renal functional recovery after laparoscopic LDN.


METHODS
We reviewed the donor and recipient records of 101 laparoscopic and 35 open LDNs performed between August 1997 and September 2001. Data were collected on demographic, immunologic, and intraoperative variables and ureteral/vascular complications. Delayed renal function recovery in recipients was evaluated by serum creatinine greater than 2.5 mg/dL on postoperative day 5, dialysis in first postoperative week, and two renographic criteria--the time to peak activity and the time to one-half peak activity on postoperative day 5. Long-term outcomes were evaluated by serum creatinine at 1, 3, 6, and 12 months and 2 and 3 years, creatinine clearance at 1 year, and patient and allograft survival.


RESULTS
Donor and recipient age, sex, body mass index, and number of HLA mismatches did not differ between the two groups. The mean operating room time and blood loss were comparable. No differences were found in the early functional parameters (renography, creatinine at postoperative day 1 and 5, or dialysis in week 1) or long-term outcome (patient and graft survival, creatinine, and rejection at 1 year and patient and graft survival at 1, 2, and 3 years).


CONCLUSIONS
Early recovery of graft function, longer term renal function, and 3-year patient and allograft survival are similar for live donor kidneys obtained by either a laparoscopic or an open surgical technique.
Derweesh
Ithaar H
IH
Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Goldfarb
David A
DA
Abreu
Sidney C
SC
Goel
Mahesh
M
Flechner
Stuart M
SM
Modlin
Charles
C
Zhou
Lingmei
L
Streem
Stevan B
SB
Novick
Andrew C
AC
Gill
Inderbir S
IS
D000328:Adult; D005260:Female; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation / Q000502:physiology*; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods; D020858:Tissue and Organ Harvesting