title: Hand assisted retroperitoneoscopic living donor nephrectomy in elderly donors.
abstract: OBJECTIVE
  We assessed the influence of HARDN on residual donor kidney and allograft function, invasiveness and morbidity in elderly living donors.
  
  
  METHODS
  A total of 89 living donors underwent nephrectomy before September 2004 at our institution. The 18 donors who were 65 years or older included 4 of 27 with ODN and 14 of 62 with HARDN.
  
  
  RESULTS
  In older (65 years or older) donors mean operative time, mean blood loss and warm ischemia time in the HARDN group did not differ from those in the ODN group. None of the donors had major complications. Older donors with HARDN had a tendency toward a shorter hospital stay than those with ODN. Postoperative serum creatinine in older donors with HARDN was higher than that in younger donors with HARDN, while there was no difference in postoperative serum creatinine between older donors with HARDN and those with ODN. The frequency of allograft losses tended to be higher in older than in younger kidneys (4 of 18 vs 5 of 71, p = 0.054). However, most allograft losses did not seem to be related to surgical technique.
  
  
  CONCLUSIONS
  Although further studies, especially with long-term followup, are necessary, HARDN is suggested to be safe and minimally invasive surgery even in elderly donors and to be comparable to open surgery in terms of morbidity, the residual donor kidney and allograft function.
authors.affiliation: Department of Urology, Akita University School of Medicine, Akita, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Tsuchiya
authors.forename: Shigeru
authors.initials: S
authors.lastname: Satoh
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iinuma
authors.forename: Shintaro
authors.initials: S
authors.lastname: Narita
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Inoue
authors.forename: Shinobu
authors.initials: S
authors.lastname: Matsuura
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space