Early and late graft function after laparoscopic hand-assisted donor nephrectomy for living kidney transplantation: comparison with open donor nephrectomy.
OBJECTIVE
Laparoscopic donor nephrectomy has become the procedure of choice for living kidney transplantation in many centers. We report on our experience with laparoscopic hand-assisted donor nephrectomy, in particular concerning graft function compared with open donor nephrectomy.


METHODS
Between 1995 and March 2007, 72 patients with end-stage renal disease have received kidney transplantation from living donors. Open living donor nephrectomy (ODN) was performed in 35 donors, whereas 37 donors had undergone laparoscopic hand-assisted nephrectomy (HALDN). Immediate graft function, serum creatinine and serum cystatin C 1 year after the transplantation were evaluated.


RESULTS
Median operative time was 138 min (113-180 min) in the HALDN group and 112 min (91-162 min) in the ODN group (p < 0.05). Warm ischemia time was 87 s (63-150 s) in the HALDN and 81 s (56-123 s) in the ODN groups, respectively (p = 0.13). Both the rate of primary graft function as well as kidney graft function parameters serum creatinine and serum cystatin C 1 year after transplantation showed no statistically significant difference between the two groups of patients.


CONCLUSIONS
Laparoscopic hand-assisted donor nephrectomy is safe and has no negative impact on the transplanted graft function when compared with open donor nephrectomy.
Hoda
M R
MR
Clinic for Urology and Kidney Transplantation Center, University Medical School of Martin-Luther-University Halle/Wittenberg, Ernst-Grube-Strasse 40, DE-06120 Halle, Saale, Germany. rhoda@ucsd.edu
Hamza
A
A
Greco
F
F
Wagner
S
S
Fischer
K
K
Fornara
P
P
D000328:Adult; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007511:Ischemia; D007668:Kidney / Q000502:physiology; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*
D055316:Cystatin C; D007166:Immunosuppressive Agents; D003404:Creatinine