Is right laparoscopic donor nephrectomy right?
BACKGROUND
Laparoscopic donor nephrectomy has become the standard of care in many renal transplant centers. Many centers are reluctant to perform right laparoscopic donor nephrectomies, primarily due to concerns about transplanting a kidney with a short renal vein.


METHODS
A retrospective review of 26 right and 24 left consecutive donor nephrectomies and their recipients was performed. Patient demographics, preoperative, perioperative, and postoperative data were recorded and compared.


RESULTS
Patient demographics were similar between groups. Multiple vessels were encountered more frequently on the right side (10 vs. 3, p = 0.04) and the donated kidney had lesser preoperative function in the right group as determined by nuclear medicine imaging (46.5% vs. 49.4%, p < 0.001). Donor operating times were less in the right group (198 vs. 226 min, p = 0.016). There was no difference in implantation difficulty as demonstrated by similar operative and warm ischemia times. Complication rates were similar between both groups of donors and recipients.


CONCLUSIONS
Right laparoscopic donor nephrectomy requires less operating time than, and is associated with similar outcomes for donors and recipients as, left laparoscopic donor nephrectomy. Right laparoscopic donor nephrectomy may be preferable in general and should be considered when multiple renal vessels are present on the left side and/or when preoperative function of the left kidney is greater than the right.
Sawatzky
Mark
M
Queen Elizabeth II Health Sciences Centre, Dalhousie University, Room 8-838 Victoria Bldg, QEII HSC, 1278 Tower Road, Halifax, NS, Canada, B3H 2Y9. msawatzk@dal.ca
Altaf
Abdulmalik
A
Ellsmere
James
J
Klassen
Dennis
D
Walsh
Mark
M
Molinari
Michele
M
Nashan
Björn
B
Bonjer
Jaap
J
D000328:Adult; D046148:Donor Selection / Q000592:standards*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods / Q000592:standards*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000592:standards