title: Laparoscopic donor nephrectomy.
abstract: BACKGROUND
  Kidney transplantation is a definitive treatment of end-stage renal disease. Laparoscopic donor nephrectomy (LDN) has been widely accepted around the world since its introduction in 1995 as a minimum invasive procedure. We report our clinical experience of 141 consecutive LDNs performed in two tertiary hospitals in Western Australia.
  
  
  METHODS
  From December 2000 (Royal Perth Hospital) and January 2005 (Sir Charles Gairdner Hospital) to January 2009, 141 LDNs were performed in two tertiary hospitals by four urologists. All donors underwent rigorous work-up prior to surgery. Donor age ranged from 23 years to 81 years (49.85 ± 11.30 years). The male to female ratio was 1 to 1.3. Donor body mass index (BMI) was 26.77 ± 4.31, and glomerular filtration rate was 96.25 ± 12.33 mL/min/1.73 sqm. The laparoscopic technique was transperitoneal approach exclusively.
  
  
  RESULTS
  All LDNs were performed successfully without hand assistance. The warm ischaemic time ranged from 3 to 11 min. The hospital stay was 4.16 ± 1.30 days. The overall complication rate was 17.0%, with three major complications (2.1%): a splenetic infarction, a chylous ascites and a pulmonary embolism occurred. Donors' demographic data (age, sex, BMI, side of surgery) did not show a statistically significant association with surgical complications.
  
  
  CONCLUSIONS
  Transperitoneal laparoscopic live donor nephrectomy is a safe and effective procedure. Combined use of vascular stapler and Hem-o-Lok is very important for management of the renal artery stump. It is our current practice to administer anticoagulants during and post-surgery for at least 2 weeks.
authors.affiliation: Western Australia Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, Nedlands, 6009, Australia. bulang.he@health.wa.gov.au
authors.forename: Bulang
authors.initials: B
authors.lastname: He
authors.forename: Andrew
authors.initials: A
authors.lastname: Mitchell
authors.forename: Luc
authors.initials: L
authors.lastname: Delriviere
authors.forename: Tom
authors.initials: T
authors.lastname: Shannon
authors.forename: Richard
authors.initials: R
authors.lastname: Pemberton
authors.forename: Andrew
authors.initials: A
authors.lastname: Tan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Bremner
authors.forename: Justin
authors.initials: J
authors.lastname: Vivian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D016030:Kidney Transplantation; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome