Risk factors for delayed graft function after hand-assisted laparoscopic donor nephrectomy.
BACKGROUND
Delayed graft function (DGF) has a negative effect on the results of living-donor kidney transplantation.


OBJECTIVE
To investigate potential risk factors for DGF.


METHODS
This prospective study included 200 consecutive living donors and their recipients between January 2002 and July 2007. Delayed graft function was defined as need for dialysis within the first postoperative week.


RESULTS
Delayed graft function was diagnosed in 12 patients (6%). Intraoperative complications occurred in 10 donors (5%), and postoperative complications in 24 donors (13.5%). One-year kidney graft survival with vs without DGF was 52% and 98%, respectively (P < .002). In donors, 2 univariate risk factors for DGF identified were lower counts per second at peak activity during scintigraphy, and multiple renal veins. In recipients, only 2 or more kidney transplantations and occurrence of an acute rejection episode were important factors. At multivariate analysis, increased risk of DGF was associated with the presence of multiple renal veins (odds ratio, 151.57; 95% confidence interval, 2.53-9093.86) and an acute rejection episode (odds ratio, 78.87; 95% confidence interval, 3.17-1959.62).


CONCLUSIONS
Hand-assisted laparoscopic donor nephrectomy is a safe procedure. The presence of multiple renal veins and occurrence of an acute rejection episode are independent risk factors for DGF.
Minnee
R C
RC
Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands. rcminnee@hotmail.com
Bemelman
W A
WA
Donselaar-van der Pant
K A M I
KA
Booij
J
J
ter Meulen
S
S
ten Berge
I J M
IJ
Legemate
D A
DA
Bemelman
F J
FJ
Idu
M M
MM
D000328:Adult; D051799:Delayed Graft Function / Q000453:epidemiology; D005190:Family; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012307:Risk Factors