title: Retroperitoneoscopic living related-donor nephrectomy: clinical outcomes of 50 consecutive cases and comparison with open donor nephrectomy.
abstract: OBJECTIVE
  To determine whether living related retroperitoneoscopic donor nephrectomy (RDN) is a safe and effective procedure.
  
  
  METHODS
  From September 2001 to May 2004, RDN was performed in 50 consecutive patients at our hospital. All patients were followed longitudinally with office visits. Perioperative and postoperative data for these RDNs, including operative time, blood loss, and complications, were compared with those of open donor nephrectomies (ODNs) performed between January 1999 and December 2001.
  
  
  RESULTS
  The RDN was completed in all cases. The average warm ischemia times were 4.1 minutes (range 1.0-8.5 minutes) and 3.5 minutes (range 2.3-5.5 minutes) in the RDN and ODN groups, respectively (P = NS). The mean operative time for RDN was significantly longer than that for ODN (P < 0.001), but patients in the RDN group had significantly shorter hospital stays (P < 0.05). There was no significant difference between the groups in blood loss during operation or number of doses of analgesics administered after the operation. Perioperative and early postoperative complications occurred in 14 patients (28%) in the RDN group and consisted of subcutaneous emphysema in 9, wound infection in 3, and persistent headache in 2 patients. All kidneys removed retroperitoneoscopically functioned immediately. No recipients required post-transplant continuous hemodialysis.
  
  
  CONCLUSIONS
  The RDN is a safe and effective procedure for both donor and recipient. Although the benefits of RDN have been demonstrated, further long-term studies of graft function and patient survival are needed.
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan. yoshimura@uro.med.osaka-u.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Shiro
authors.initials: S
authors.lastname: Takahara
authors.forename: Miyaji
authors.initials: M
authors.lastname: Kyakuno
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Osamu
authors.initials: O
authors.lastname: Miyake
authors.forename: Masao
authors.initials: M
authors.lastname: Tsujihata
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Ichimaru
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyagawa
authors.forename: Ryo-Ichi
authors.initials: R
authors.lastname: Imamura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D015505:Chest Tubes; D003289:Convalescence; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D007902:Length of Stay; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D012187:Retroperitoneal Space; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods