Why we consistently use the left donor kidney in living related transplantation: initial experience of right laparoscopic donor nephrectomy and comparison with left nephrectomy.
OBJECTIVE
Laparoscopic donor nephrectomy has become the method of choice for removal of living donor kidneys. However, the majority of laparoscopic donor nephrectomy cases have been limited to the left side owing to technical difficulties and renal vessel length. This study described the technique and compared donor outcomes and graft function of right and left laparoscopic donor nephrectomy.


METHODS
Among 25 patients, 6 consecutive donors underwent right laparoscopic donor nephrectomy from March 2002 to January 2005. They were compared to 19 patients with left laparoscopic donor nephrectomy. We compared operative times, warm ischemia times, serial creatinines, creatinine clearances, complications, and graft function.


RESULTS
There was no significant difference in any metric. The operative times (303 min. vs 274 min., P > .05) and warm ischemia times (133 s vs 186 s, P > .05) were similar between right and left laparoscopic donor nephrectomy procedures. In left laparoscopic donor nephrectomy, 3 patients had transient brachial plexus neuropathies. No major complication occurred among patients undergoing right laparoscopic donor nephrectomy. This study demonstrated that both donor and recipient outcomes are similar for right and left laparoscopic donor nephrectomy.


CONCLUSIONS
Consistent use of the left kidney has not affected clinical outcomes. With hand-assisted laparoscopy, the right laparoscopic donor nephrectomy is safe, providing excellent graft function.
Liu
K-L
KL
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Kewishan Hsiang, Taoyuan 333, Taiwan.
Chiang
Y-J
YJ
Wu
C-T
CT
Lai
W-J
WJ
Wang
H-H
HH
Chu
S-H
SH
D000328:Adult; D003404:Creatinine / Q000378:metabolism; D005190:Family; D007839:Functional Laterality; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D010535:Laparoscopy; D019520:Living Donors; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome
D003404:Creatinine