A decade of minimally invasive donation: experience with more than 1200 laparoscopic donor nephrectomies at a single institution.
BACKGROUND
The past decade has seen laparoscopic donor nephrectomy (LDN) transform into a standard of care procedure. Furthermore, LDN has evolved with the introduction of new technologies aimed at increasing efficiency and safety. There are few large, single center experiences detailing the results of LDN, its associated complications, and their management.


METHODS
We performed a retrospective review of 1200 LDN performed at our center for both pediatric and adult recipients.


RESULTS
Mean body mass index of donors was 27.1 (range 17-48). Twenty-six percent of kidneys had multiple renal arteries. Greater than 99% were left LDN. Mean length of stay was 1.37 +/- 0.6 d, which decreased to 1.1 +/- 0.5 d for the last 475 cases. The overall complication rate was 5.6%. Among those patients, 1.6% of the patients experienced an intraoperative complication, including eight renovascular injuries; 7/8 renovascular injuries led to open conversion. Four conversions were elective; our overall conversion rate was 0.92%; 4.0% had a post-operative complication; 1.2% required readmission for complication management. Three of 1200 patients have required reoperation for prolonged ileus and internal hernia (2), respectively. There have been no cases of donor renal failure or death. Since 2003, we have routinely used hand-assisted LDN (HALDN). There have been no cases of primary non-function. Urologic complications have been uncommon.


CONCLUSIONS
Our series supports the safety and efficacy of LDN/HALDN.
Leventhal
Joseph R
JR
Division of Organ Transplant, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. jleventh@nmh.org
Paunescu
Smaranda
S
Baker
Talia B
TB
Caciedo
Juan Carlos
JC
Skaro
Anton
A
Kocak
Burak
B
Gallon
Lorenzo
L
Friedewald
John
J
Luo
Xunrong
X
Kaufman
Dixon B
DB
Fryer
Jonathan P
JP
Abecassis
Michael M
MM
D000328:Adult; D015992:Body Mass Index; D051799:Delayed Graft Function / Q000453:epidemiology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D019520:Living Donors; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome