title: Long-term graft function in a randomized clinical trial comparing laparoscopic versus open donor nephrectomy.
abstract: OBJECTIVE
  To evaluate and compare the long-term graft and survival rates in kidney transplant recipients who had undergone laparoscopic donor nephrectomy versus those who underwent open donor nephrectomy.
  
  
  METHODS
  Our study was done with 100 cases of laparoscopic donor nephrectomy and 100 cases of open donor nephrectomy, performed between July 2001 and September 2003. Mean follow-up of recipients in this study was 6.6 ± 2.4 years (range, 1-9.3 y). This study has a longer follow-up than previous randomized clinical trials. We compared patient and graft survival in recipients of laparoscopic donor nephrectomy versus those who had open donor nephrectomy.
  
  
  RESULTS
  Mean duration of kidney warm ischemia time was 8.7 ± 2.7 minutes for laparoscopic donor nephrectomy and 1.8 ± 0.92 minutes for open donor nephrectomy. There were no significant differences in 5-year graft survival between the laparoscopic donor nephrectomy and open donor nephrectomy groups (89.5% vs 84.3%; P = .96). There were no differences in delayed graft function between the laparoscopic donor nephrectomy and open donor nephrectomy groups (8 and 11 patients; P = .135). There was a significant difference in 5-year graft survival between recipients with a history of delayed graft function and those without delayed graft function (63.2% vs 89.7%; P = .04). Despite a longer warm ischemia time in laparoscopic donor nephrectomy group (8.69 vs 1.87 min; P = .0001), warm ischemia time had no effect on graft outcome in long-term follow-up.
  
  
  CONCLUSIONS
  Although earlier experiences with laparoscopic donor nephrectomies were associated with concerns about long-term effects of laparoscopic donation on the graft function in the recipient, our long-term results confirm that laparoscopic donor nephrectomy provides similar graft outcome to open donor nephrectomy.
authors.affiliation: Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University, M.C., Tehran, IR Iran. simforoosh@iurtc.org.ir
authors.forename: Nasser
authors.initials: N
authors.lastname: Simforoosh
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.forename: Nasser
authors.initials: N
authors.lastname: Shakhssalim
authors.forename: Shahram
authors.initials: S
authors.lastname: Gooran
authors.forename: Ali
authors.initials: A
authors.lastname: Tabibi
authors.forename: Ali
authors.initials: A
authors.lastname: Khoshdel
authors.forename: Seyed Amir Mohsen
authors.initials: SA
authors.lastname: Ziaee
mesh_terms: D000328:Adult; D051799:Delayed Graft Function / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods* / Q000401:mortality; D055031:Primary Graft Dysfunction / Q000401:mortality*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult