Health-related quality of life after living donor nephrectomy: a randomized controlled trial of laparoscopic versus open nephrectomy.
BACKGROUND
The aim of this study was to compare patient-reported health status and quality of life after randomization to laparoscopic donor nephrectomy (LDN) or short-incision open donor nephrectomy (ODN).


METHODS
Live kidney donors were randomized in a 2:1 ratio to LDN (n=56) or ODN (n=28). Health-related quality of life was assessed using the Short Form 36 questionnaire preoperatively and at 6 weeks postdonation.


RESULTS
Postoperative morphine requirement was lower in the LDN group (median [range], 59 [6-136]) versus ODN group (90 [35-312] mg; P=0.001). Norm adjusted physical components scores decreased significantly at 6 weeks in both the LDN and ODN groups. The bodily pain domain score of physical components score at 6 weeks returned to baseline in the laparoscopic group (86.4±19.8 vs. 81.8±15.9; P=0.2277) but not in the open group (87.3±18.3 vs. 69.0±25.0; P=0.05). The mental component score decreased in the ODN group (53.5±7.6 vs. 45.3±10.1; P=0.0084) but returned to baseline 6 weeks after LDN (53.8±6.5 vs. 51.9±7.2; P=0.2931).


CONCLUSIONS
Donors undergoing laparoscopic nephrectomy reported less bodily pain in the first 6 weeks postdonation, and this was associated with an improved mental health component of quality of life compared with ODN (51.9±7.2 vs. 45.3±10.1; P=0.0009).
Department of Infection, Immunity and Inflammation, University of Leicester, Leicester General Hospital, Leicester, UK. mln2@le.ac.uk
Michael L
ML
Nicholson
Rosemary
R
Elwell
Monika
M
Kaushik
Atul
A
Bagul
Sarah A
SA
Hosgood
D000328:Adult; D000701:Analgesics, Opioid; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D016030:Kidney Transplantation; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009392:Nephrectomy; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D011788:Quality of Life; D020858:Tissue and Organ Harvesting
D000701:Analgesics, Opioid; D009020:Morphine