Results and complications of 50 laparoscopic nephrectomies for live donor renal transplantation.
Living donors represent 30% of kidneys for renal transplantation. Laparoscopic nephrectomy is the best surgical procedure due to its clear advantages: low morbidity, less blood transfusion requirements, and shorter donor hospitalization. From March 2002 to August 2004, we performed 50 laparoscopic nephrectomies for transplantation to recipients who were prescribed tacrolimus (0.1 mg/kg bid), mycophenolate mofetil (1 gr bid), and prednisone (0.5-1 mg/kg per day PO from 48 hours before transplantation). Mean surgery time was 170 minutes (120-260); warm ischemia time, 3.1 minutes (1.5-10); and cold ischemia time, 1.27 hours (0.85-4). Mean bleeding was 270 cc (100-900), and mean donor hospitalization was 5.5 days (3-9). Four cases required conversion of the laparoscopic procedure to open surgery because of bleeding. Seventy-two hours posttransplantation, the mean plasma creatinine was 170 micromol/L. None of the patients suffered delayed graft function. Eighteen percent experienced acute rejection episodes. Donor and recipient survivals were 100% at 1 year, and graft survival, 94% (kidney losses were due to acute rejection, severe acute pancreatitis, and surgical complications).
Guirado
L I
LI
Transplantation Unit, Nephrology Service, Fundació Puigvert, Barcelona, Spain. lguirado@fundacio-puigvert.es
Díaz
J M
JM
Facundo
C
C
Alcaraz
A
A
Rosales
A
A
García-Masset
R
R
Sainz
Z
Z
Chuy
E
E
Solà
R
R
D004651:Employment; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods / Q000401:mortality / Q000502:physiology*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D007902:Length of Stay; D019520:Living Donors; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000145:classification; D016019:Survival Analysis; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents