Outcome of laparoscopic live donor nephrectomy in 2005: National survey of Japanese transplantation centers.
The increased acceptance of laparoscopic nephrectomy (LN) has been a driving force for live donor kidney transplantation. However, the outcomes of LN in live donors has not yet been clarified in Japan. In this study, we surveyed 125 Japanese kidney transplantation centers to investigate the current status of live donor LN. Of 125 centers, the 98 that responded had performed 695 live donor nephrectomies. Among these centers, 43 had performed LN. Among the 695 nephrectomies, 441 donors had undergone LN and 254, open nephrectomies. In 43 centers, 16 were performed as hand-assisted (HA) LN; 20, non-HA; 3, both HA and non-HA; and 5 laparoscope-assisted. Ten centers used a peritoneal approach; 30, a retroperitoneal; and 3, both. In 441 LN donors, 1 had a life-threatening complication of deep venous thrombosis and survived. Blood transfusions were performed in 7 donors. Open conversions from LN were necessary in 24. Minor complications not requiring prolonged hospital stay were reported in 52. The mortality of LN was zero. In contrast, among the 441 recipients, 1 case was reported as primary nonfunction after venous misadventure in the operation and 30 recipients needed hemodialysis after transplantation because of delayed graft function. Urinary tract complications were noted in 11 recipients. This survey presented the current status of the procedure, providing a base for informed consent from potential donors.
Yuzawa
K
K
National Hospital Organization Mito Medical Center, Department of Transplantation Surgery, Ibaraki-Ken, Japan. k.yuzawa.d@mn.hosp.go.jp
Shinoda
M
M
Fukao
K
K
D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D003625:Data Collection; D006801:Humans; D007564:Japan; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors / Q000706:statistics & numerical data*; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012042:Registries; D012449:Safety; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*