Systemic heparinisation in laparoscopic live donor nephrectomy.
Introduction. Systemic heparinisation is advocated during laparoscopic live donor nephrectomy (LDN) as a preventative measure against renal vascular thrombosis during the warm ischaemic interval. This study compares the outcome with and without the administration of systemic heparinisation. Methods. A retrospective analysis was performed on 186 consecutive LDN patients between April 2008 and November 2012. Systemic heparin (2000-3000 IU) was administered intravenously to donors (hep n = 109). From January 2010, heparin was not used systemically in this group of LDN (no hep n = 77). Outcome measures included donor and recipient complications, initial graft function, and 12 month graft survival. Results. The demographics of both heparinised and non-heparinised donors were similar. The warm ischaemic time (WIT) was comparable in both groups (WIT; hep 5 ± 3 versus no hep 5 ± 3 minutes; P = 1.000). There was no difference in complication rates, no episodes of graft thrombosis, and no incidences of primary nonfunction in either group. Delayed graft function occurred in 4/109 and 1/77 (3.6% versus 1.2%; P = 0.405) and there was no significant difference in graft survival (P = 0.650). Conclusion. Omitting systemic heparinisation during laparoscopic donor nephrectomy is a feasible and safe approach that does not compromise donor or recipient outcome.
Transplant Group, Department of Infection, Immunity and Inflammation, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK.
Charlotte
C
Crotty
Transplant Group, Department of Infection, Immunity and Inflammation, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK.
Yasmin
Y
Tabbakh
Transplant Group, Department of Infection, Immunity and Inflammation, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK.
Sarah A
SA
Hosgood
Transplant Group, Department of Infection, Immunity and Inflammation, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK.
Michael L
ML
Nicholson