title: Laparoscopic versus open renal procurement for pediatric recipients of living donor renal transplantation.
abstract: Despite reports demonstrating the safety of laparoscopic donor nephrectomy (LDN) for pediatric recipients of renal transplants, recent evidence has challenged using LDN for recipients 5 years of age or younger. We retrospectively reviewed the records of all pediatric recipients of living donor renal transplants from September 2000 through August 2004. We compared those who received allografts recovered by LDN (n = 34) with those recovered by open donor nephrectomy (ODN, n = 26). Outcomes of interest included operative complications, postoperative renal function, the incidence of delayed graft function or episodes of acute rejection and long-term graft function. Donor and recipient demographic data were similar for the LDN and ODN groups. Serum creatinine and calculated creatinine clearance were not significantly different between groups both in the early postoperative period and at long-term follow-up (p > 0.142). Rates of delayed graft function and acute rejection did not differ between groups. Among recipients aged 5 years old or younger stratified by donor technique (9 LDN, 5 ODN recipients), no difference was noted in graft outcomes both early and long-term (p > 0.079). At our center, pediatric LDN recipients have graft outcomes comparable to those of ODN recipients. At experienced centers, we recommend continued use of LDN for pediatric recipients of all ages.
authors.affiliation: Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA. jsinger@mednet.ucla.edu
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Singer
authors.forename: Robert B
authors.initials: RB
authors.lastname: Ettenger
authors.forename: John L
authors.initials: JL
authors.lastname: Gore
authors.forename: H Albin
authors.initials: HA
authors.lastname: Gritsch
authors.forename: Jacob
authors.initials: J
authors.lastname: Rajfer
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Rosenthal
authors.forename: Peter
authors.initials: P
authors.lastname: Schulam
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods; D012077:Renal Artery; D012189:Retrospective Studies; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome
chemical_list: D003404:Creatinine