Retroperitoneoscopic living related-donor nephrectomy: clinical outcomes of 50 consecutive cases and comparison with open donor nephrectomy.
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.
Yoshimura
Kazuhiro
K
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan. yoshimura@uro.med.osaka-u.ac.jp
Takahara
Shiro
S
Kyakuno
Miyaji
M
Yamaguchi
Seiji
S
Yoshioka
Toshiaki
T
Miyake
Osamu
O
Tsujihata
Masao
M
Ichimaru
Naotsugu
N
Miyagawa
Yasushi
Y
Imamura
Ryo-Ichi
R
Okuyama
Akihiko
A
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