title: Maximizing the donor pool: left versus right laparoscopic live donor nephrectomy--systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the current evidence regarding the efficiency, safety, and potential advantages of right-laparoscopic live donor nephrectomy (LLDN) compared with left-LLDN.
  
  
  METHODS
  We comprehensively searched PubMed, Embase, the Cochrane Library, and Web of Science to perform a systematic review and cumulative meta-analysis of a randomized controlled trial (RCT) and prospective and retrospective comparative studies assessing the two techniques.
  
  
  RESULTS
  A single RCT and 28 comparative studies including a total of 32,426 cases were identified. Although left-LLDN was associated with lower delayed renal function [odds ratio (OR) 0.73; 95 % confidence interval (CI) 0.62, 0.87, p = 0.0003] and less thrombosis (OR 0.35; 95 % CI 0.13, 0.96, p = 0.04) in our meta-analysis, sensitivity analysis did not show any significant difference between the two groups. There were no other considerable differences between the two groups.
  
  
  CONCLUSIONS
  With enough surgical experience, right-LLDN can be performed with equivalent safety and efficacy. Although large-volume centers are routinely performing right-LLDN, there is under appreciation of the right side in smaller centers given the associated fear of poor outcomes and technically demanding procedure. Due to the inherent limitations of the included studies, future well-designed RCTs are awaited to confirm and update the findings of this analysis.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Nian
authors.initials: N
authors.lastname: Liu
authors.forename: Romel
authors.initials: R
authors.lastname: Wazir
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.forename: Kun-Jie
authors.initials: KJ
authors.lastname: Wang
mesh_terms: D016063:Blood Loss, Surgical; D061887:Conversion to Open Surgery; D051799:Delayed Graft Function / Q000209:etiology; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D007902:Length of Stay; D019520:Living Donors; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D013927:Thrombosis / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D052096:Warm Ischemia