Laparoscopic v open donor nephrectomy for pediatric kidney recipients: preliminary report of a randomized controlled trial.
OBJECTIVE
Laparoscopic surgery is widely accepted for nephrectomy in adult renal transplantation. The success of this technique has not been compared with open donor nephrectomy (ODN) in children.


METHODS
In this randomized clinical trial, 40 adult kidney donors were randomly divided into two groups: 20 cases of laparoscopic donor nephrectomy (LDN) and 20 of ODN. Recipients had an age of <15 years. Our exclusion criteria were previous renal transplantation, hemolytic uremic syndrome, focal segmental glomerulosclerosis, oxalosis in the recipients, and multiple renal arteries bilaterally in donors.


RESULTS
All donor nephrectomies were completed as scheduled, and no patients undergoing LDN required conversion to open nephrectomy. No patients in either the ODN or the LDN group required reoperation. Acute rejection was diagnosed in six patients receiving kidneys procured by ODN (30%) and 4 patients (20%) receiving kidneys obtained by LDN (P = 0.3). No recipients or donors died. At 1 year, the graft survival times in the ODN and LDN groups were 310.8 +/- 28.8 and 302.7 +/- 28.2 days, respectively (P = 0.8).


CONCLUSIONS
At our medical center, pediatric LDN recipients had graft outcomes similar to those of ODN recipients. We recommend LDN for harvest of kidneys for pediatric recipients at experienced centers.
Basiri
A
A
Department of Urology and Renal Transplantation, Urology and Nephrology Research Center, Shahid Labbafi Nejad Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. h_sasan@hotmail.com
Simforoosh
N
N
Heidari
M
M
Moghaddam
S M Hosseini
SM
Otookesh
H
H
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome