Early graft function in kidney transplantation: comparison between laparoscopic donor nephrectomy and open donor nephrectomy.
Laparoscopic donor nephrectomy (LN) offers less postoperative pain and early recovery in living kidney donors, but graft kidney function in the recipients can be delayed due to prolonged warm ischemic time (WIT) and adverse effects of pneumoperitoneum. We compared the early function of the grafted kidney and the complications in kidney recipients after LN versus open nephrectomy (ON). We analyzed 109 kidney recipients from living donors, including 60 LN and 49 ON, comparing immediate diuresis after surgery, glomerular filtration rate (GFR) by MDRD formula (modification of diet in renal disease) at day 5, and complications. The recipient age among the LN group was 20 to 73 years with 51% men among whom 95% of patients had immediate diuresis with GFR at day 5 varying from 4.85 to 99.45 mL/min/1.73 m(2) by MDRD Surgical complications were renal artery stenosis (5%) and urinary leakage (5%). The recipient among age ON cases varied from 18 to 63 years with 63% men and immediate diuresis observed in 87% and GFR at day 5 varied from 4.75 to 101.1 mL/min/1.73 m(2) by MDRD. Renal artery stenosis was observed in 8.16%. The WIT was longer (P < .05) among the LN (1.4 to 11 minutes) compared with the ON group (1 to 4 minutes). GFR at day 5 showed no difference between the two groups. In conclusion, WIT was higher among LN compared with ON but did not seem to influence early function of the grafted kidney.
Percegona
L S
LS
Transplant Unit Hospital Santa Casa de Misericórdia de Curitiba, Curitiba, Paraná, Brazil. l.percegona@pucpr.br
Bignelli
A T
AT
Adamy
A
A
Machado
C
C
Pilz
F
F
Meyer
F
F
Hokazono
S R
SR
Riella
M C
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D004231:Diuresis; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D012189:Retrospective Studies