title: Long-term outcomes of living donor kidney transplants in pediatric recipients following laparoscopic vs. open donor nephrectomy.
abstract: We compared long-term outcomes of LDKT in pediatric recipients following either laparoscopic (LDN) or ODN. In our retrospective single-center study, we compared 38 pediatric LDKT recipients of a laparoscopically procured kidney with a historic ODN group comprising 17 pediatric recipients. In our center, the first pure laparoscopic non-hand-assisted LDN for a pediatric LDKT recipient was performed in June 2001. Demographic data of donors and recipients were comparable between groups. Mean follow-up was 64 months in the LDN group and 137 months in the ODN group. Patient survival was comparable between groups. Graft survival at one and five yr was 97% (LDN) vs. 94% (ODN) and 91% (LDN) vs. 88% (ODN; p = n.s.), respectively. Serum creatinine at one and five yr was 1.16 ± 0.47 mg/dL (LDN) vs. 1.02 ± 0.38 mg/dL (ODN) and 1.38 ± 0.5 mg/dL (LDN) vs. 1.20 ± 0.41 mg/dL (ODN), respectively. The type and frequency of surgical complications did not differ between groups. DGF and acute rejection rates were similar between groups. In the ODN group, a higher proportion of right donor kidneys was used. In the ODN group, all kidneys had singular arteries, whereas in the LDN group five kidneys had multiple arteries. Arterial multiplicity was associated with a higher incidence of DGF. In our experience, LDN does not compromise long-term graft outcomes in pediatric LDKT recipients. Arterial multiplicity of the donor kidney may be a risk factor for impaired early graft function in the pediatric population.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Lyubov
authors.initials: L
authors.lastname: Chaykovska
authors.forename: Serdar
authors.initials: S
authors.lastname: Deger
authors.forename: Jan
authors.initials: J
authors.lastname: Roigas
authors.forename: Andre
authors.initials: A
authors.lastname: Lenz
authors.forename: Poline
authors.initials: P
authors.lastname: Lioudmer
authors.forename: Lisa T
authors.initials: LT
authors.lastname: Kothmann
authors.forename: Frank
authors.initials: F
authors.lastname: Friedersdorff
authors.forename: Dominik
authors.initials: D
authors.lastname: Müller
authors.forename: Antje
authors.initials: A
authors.lastname: Kasper
authors.forename: Markus
authors.initials: M
authors.lastname: Giessing
authors.forename: Ahmed
authors.initials: A
authors.lastname: Magheli
authors.forename: Carsten
authors.initials: C
authors.lastname: Kempkensteffen
authors.forename: Anja
authors.initials: A
authors.lastname: Lingnau
authors.forename: T Florian
authors.initials: TF
authors.lastname: Fuller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine