title: Laparoscopic live donor nephrectomy: the pediatric recipient in a dual-site program.
abstract: BACKGROUND
  At our institution, laparoscopic live donor nephrectomy (LLDN) is done at a different hospital site than pediatric recipient transplantation, whereas open donor nephrectomy (OLDN) is done in the adjacent operating room. The purpose of this study was to evaluate the safety of a dual-site renal transplantation program by comparing the outcomes of pediatric recipients of LLDN vs. OLDN.
  
  
  METHODS
  This is a retrospective study of consecutive pediatric recipients (n = 10) of LLDN (June 2002 to June 2005) compared to the 10 most recent pediatric recipients of OLDN (March 2001 to June 2005). Renal function was assessed with calculated creatinine clearance using the Schwartz formula and the following outcomes were assessed: delayed graft function, ureteral complications, acute rejection and patient and graft survival. Results are expressed as median (IQR).
  
  
  RESULTS
  When comparing the laparoscopic vs. open group, there were no significant differences in recipient age, height, weight, preoperative calculated creatinine clearance and warm ischemia time. Twelve month postoperative creatinine clearance was 88 ml/min/1.73 m(2) (57-99) in the laparoscopic group (n = 8) and 66 ml/min/1.73 m(2) (60-86) in the open group (n = 9), p = 0.2. In the LLDN group vs. the OLDN group, delayed graft function was 0% vs. 10% (p = 1.0), ureteral complications were 20% vs. 30% (p = 1.0), and acute rejection was 20% vs. 40% (p = 0.6). In the laparoscopic group, one-yr patient and graft survival were both 100%, as compared to 100% and 89%, respectively, in the open group.
  
  
  CONCLUSIONS
  A dual-site laparoscopic donor nephrectomy program is not associated with adverse pediatric recipient outcomes when compared to a same-site open donor approach.
authors.affiliation: Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Bergman
authors.forename: Andrew
authors.initials: A
authors.lastname: Feifer
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
authors.forename: Lorraine
authors.initials: L
authors.lastname: Bell
authors.forename: Helene
authors.initials: H
authors.lastname: Flageole
authors.forename: Jean
authors.initials: J
authors.lastname: Tchervenkov
authors.forename: Maurice
authors.initials: M
authors.lastname: Anidjar
authors.forename: Donna
authors.initials: D
authors.lastname: Stanbridge
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Fried
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D015397:Program Evaluation / Q000379:methods*; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome