title: Prospective, nonrandomized comparison between right- and left-sided hand-assisted laparoscopic donor nephrectomy.
abstract: BACKGROUND
  Despite technical improvements, laparoscopic living donor right nephrectomy can be associated with difficulties to obtain a sufficient lengths of right renal vessels. We report our experience with right-sided, hand-assisted, laparoscopic donor nephrectomy (HALDN).
  
  
  METHODS
  During a 7-year period (2003-2010), right HALDN was performed on 51 and left HALDN on 40 living kidney donors. We prospectively collected perioperative outcome data in donors and recipients including graft function and calculated 1-year graft survival according to the Kaplan-Meier-method.
  
  
  RESULTS
  There were no conversions. The mean procedure time was 123 minutes versus 135 minutes for left HALDN (P = .09). Mean blood loss was 92 mL versus 101 mL in left HALDN (P = .09). There was no renal artery or vein thrombosis. The mean warm ischemia time was 47 seconds versus 41 seconds in left HALDN (P = .21). Hospital discharge was on an average at 3.4 days postoperatively. Delayed graft function occurred in two recipients: one in the left group and the other in the right group. Further, no significant difference in serum creatinine values was seen between the groups at 1 year after the transplantation. One-year graft survival rate was 97.5% in the left versus 98.1% in the right group.
  
  
  CONCLUSIONS
  Right HALDN is as safe and feasible as left HALDN. Hand-assistance results in a convenient length of right renal vessels without an increased incidence of vascular thrombosis.
authors.affiliation: Clinic for Urology and Kidney Transplantation Center, University Medical School of Martin-Luther-University Halle/Wittenberg, Halle, Germany. rhoda@ucsd.edu
authors.forename: M R
authors.initials: MR
authors.lastname: Hoda
authors.forename: F
authors.initials: F
authors.lastname: Greco
authors.forename: S
authors.initials: S
authors.lastname: Wagner
authors.forename: H
authors.initials: H
authors.lastname: Heynemann
authors.forename: P
authors.initials: P
authors.lastname: Fornara
mesh_terms: D000328:Adult; D005260:Female; D007839:Functional Laterality; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies