title: Open and laparoscopic living donor nephrectomy in Switzerland: a retrospective assessment of clinical outcomes and the motivation to donate.
abstract: BACKGROUND
  Laparoscopic living kidney nephrectomy is thought to be associated with reduced morbidity, when compared to open nephrectomy. The purpose of this study was to explore the impact of these techniques on donors' clinical outcomes, satisfaction and motivation to donate.
  
  
  METHODS
  Clinical outcomes were retrospectively compared in 152 open (n = 71) or laparoscopic (n = 81) donor procedures. Donor satisfaction and motivation were assessed with a self-administered questionnaire.
  
  
  RESULTS
  The complication rate was the same with both procedures and the majority of complications were mild. Laparoscopy was significantly less painful and resulted in an insignificantly faster return to active life. More than 80% of the donors volunteered to donate without pressure. Worries about future health status, pain or scars were not important in the decision to donate. Similarly, only 15% considered the surgical procedure as instrumental for their decision. Few donors currently worried about their health with one kidney and more than 95% of the donors in both groups stated that they would give their kidney again.
  
  
  CONCLUSIONS
  Living donor nephrectomy is safe, regardless of the procedure used. Although the laparoscopic nephrectomy offers clear short-term benefits over the open nephrectomy, donors' satisfaction was excellent with both surgical approaches. Moreover, the type of procedure did not seem to influence their decision to donate.
authors.affiliation: Department of Visceral and Transplantation Surgery, University Hospital Zurich, Rämistr. 100, CH-8091 Zurich, Switzerland.
authors.forename: Felix
authors.initials: F
authors.lastname: Dahm
authors.forename: Markus
authors.initials: M
authors.lastname: Weber
authors.forename: Benjamin
authors.initials: B
authors.lastname: Müller
authors.forename: Françoise G
authors.initials: FG
authors.lastname: Pradel
authors.forename: Guido F
authors.initials: GF
authors.lastname: Laube
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Neuhaus
authors.forename: Claude
authors.initials: C
authors.lastname: Cao
authors.forename: Rudolf P
authors.initials: RP
authors.lastname: Wüthrich
authors.forename: Gilbert T
authors.initials: GT
authors.lastname: Thiel
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Clavien
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000523:psychology*; D010535:Laparoscopy; D007813:Laparotomy; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009392:Nephrectomy / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome