Change in renal function after laparoscopic donor nephrectomy for kidney transplantation.
BACKGROUND
Laparoscopic donor nephrectomy (LDN) has become the method of choice for living-donor kidney transplantation. However, LDN may result in decreased renal function in the donor, and risk of end-stage renal failure has been reported.


OBJECTIVE
To evaluate changes in renal function after LDN.


METHODS
The study included 51 living donors of renal transplants between March 2002 and December 2008. Before kidney donation, we computed the initial function of the kidney preserved in the donor using 24-hour creatinine clearance (Ccr) and functional ratio as revealed at technetium 99m dimercaptosuccinic acid renal scanning. After kidney donation, serum creatinine concentration (sCr) and Ccr were calculated on postoperative day 2 and every 3 months thereafter.


RESULTS
After LDN, mean sCr increased immediately, from 0.90 to 1.31, as did Ccr of the kidney preserved in the donor, from 58.2 to 79.6, a 36.9% increase. A greater percent increase in function was observed in younger donors and those with lower initial Ccr of the preserved kidney. Although 9.8% of donors demonstrated slightly decreased renal function of the preserved kidney at last follow-up, renal function was adequately preserved in most donors.


CONCLUSIONS
Younger donors and those with lower initial function of the preserved kidney before nephrectomy demonstrate a greater increase in function after nephrectomy. Age might be a risk factor for decreased renal function after LDN. Older potential living donors may need more careful evaluation before kidney donation.
Chien
C-H
CH
Graduate Institute of Clinical Medical Sciences, Department of Surgery, School of Nursing, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Wang
H-H
HH
Chiang
Y-J
YJ
Chu
S-H
SH
Liu
H-E
HE
Liu
K-L
KL
D000328:Adult; D015992:Body Mass Index; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies
D003404:Creatinine