title: A single center comparison of long-term outcomes of renal allografts procured laparoscopically versus historic controls procured by the open approach.
abstract: We have previously reported that renal allografts procured by the laparoscopic live donor nephrectomy (lapNx) demonstrate worse early renal outcomes but noninferior 1-year renal function as compared to those procured by the standard open nephrectomy (openNx). We undertook this study to examine whether the apparent early dysfunction will impair long-term renal allograft survival. We retrospectively updated the status of the first 132 consecutive adult left lapNx recipients at our center and the preceding 99 adult openNx recipients. With a mean follow-up of 5.8+/-2.0 years in lapNx and 8.7+/-3.3 years in openNx, we found that death-censored renal allograft survival was identical on univariate and multivariate analysis. Patient survival was worse (log rank P-value=0.048) in lapNx, but this finding did not persist in multivariate analysis. Combined graft-patient survival as well as 1-year mean serum creatinine levels were similar on univariate and multivariate analyses. We conclude that, despite having suffered early renal dysfunction, the lapNx cohort of renal allograft recipients enjoys similar long-term renal allograft survival as compared to openNx.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. jnogueir@medicine.umaryland.edu
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Nogueira
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Jacobs
authors.forename: Abdolreza
authors.initials: A
authors.lastname: Haririan
authors.forename: Michael W
authors.initials: MW
authors.lastname: Phelan
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Weir
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Seliger
authors.forename: Heather A
authors.initials: HA
authors.lastname: Hurley
authors.forename: Matthew
authors.initials: M
authors.lastname: Cooper
mesh_terms: D016022:Case-Control Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D020858:Tissue and Organ Harvesting / Q000379:methods*