title: Results in laparoscopic living donor nephrectomy: a multicentric experience.
abstract: OBJECTIVE
  Renal transplantation is the most successful therapy to improve survival and quality of life for patients with end-stage renal disease. Living donors have been used as an alternative to reduce the stay on the waiting list. Laparoscopic living donor nephrectomy has become the standard procedure for renal transplantation. Minimally invasive surgery involves less postoperative pain with less analgesic requirements allowing shorter hospital stay for the donor.
  
  
  METHODS
  We retrospectively analyzed demographic and intraoperative data and surgical complications for 46 patients who underwent laparoscopic living donor nephrectomy between March 2001 and March 2011.
  
  
  RESULTS
  Mean donor age was 41 years. Mean operative time was 170 ± 45 minutes. The average cold ischemic time was 40 minutes and warm ischemic time was 26 minutes. Twenty-one patients were donors for pediatric receptors. Fourty patients underwent left laparoscopic nephrectomy, the other 6 patients underwent right laparoscopic nephrectomy due to vascular anatomic variant. Right laparoscopic nephrectomy was converted in 1 case (2.2%) due to renal vein laceration without donor morbidity and without compromise of graft function. Renal function at the second day post donor nephrectomy was measured using serum creatinine averaged 1.2 mg/dL with a mean increase of 0.4 mg/dL from baseline, with normalization after 30 days. No patient required blood transfusion, and there were no immediate surgical complications, infections, or mortality. One patient developed an incisional hernia in relation to the site of kidney removal. The mean hospital stay was 5 ± 1 days.
  
  
  CONCLUSIONS
  Laparoscopic nephrectomy in our experience is a safe technique without postoperative morbidity or mortality. It is associated with low levels of pain, early discharge and early return to physical activity and work, good sense of aesthetic results, and long-term graft function comparable to traditional nephrectomy and cadaveric grafts.
authors: Unit of Transplantation, Clínica las Condes, Santiago, Chile. Electronic address: mferrario@clc.cl.
authors: M
authors: M
authors: Ferrario
authors: E
authors: E
authors: Buckel
authors: C
authors: C
authors: Astorga
authors: J
authors: J
authors: Godoy
authors: J
authors: J
authors: Aguiló
authors: G
authors: G
authors: González
authors: J
authors: J
authors: Ormazábal
authors: A
authors: A
authors: Cámbara
authors: C
authors: C
authors: Derosas
authors: C
authors: C
authors: Herzog
authors: L
authors: L
authors: Calabrán
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002677:Chile; D050377:Cold Ischemia; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D015415:Biomarkers; D003404:Creatinine