title: Transperitoneal laparoscopic left versus right live donor nephrectomy: Comparison of outcomes.
abstract: BACKGROUND
  Although laparoscopic donor nephrectomy (LDN) is being performed at many centers, there are reservations on the routine use of laparoscopy for harvesting the right kidney due to a perception of technical complexity and increased incidence of allograft failure, renal vein thrombosis and the need for more back-table reconstruction along with increased operative time.
  
  
  METHODS
  We performed a prospective non-randomized comparison of transperitoneal laparoscopic left donor nephrectomy (LLDN) with laparoscopic right donor nephrectomy (RLDN) from August 2008 to May 2013. The operative time, warm ischemia time, intraoperative events, blood loss and post-operative parameters were recorded. The renal recipient parameters, including post-operative creatinine, episodes of acute tubular necrosis (ATN)  and delayed graft function were also recorded.
  
  
  RESULTS
  A total of 188 LDN were performed between August 2008 and May 2013, including 164 LLDN and 24 RLDN. The demographic characteristics between the two groups were comparable. The operative duration was in favor of the right donor group, while warm ischemia time, estimated blood loss and mean length of hospital stay were similar between the two groups. Overall renal functional outcomes were comparable between the two donor groups, while the recipient outcomes including creatinine at discharge were also comparable.
  
  
  CONCLUSIONS
  RLDN has a safety profile comparable with LLDN, even in those with complex vascular anatomy, and can be successfully performed by the transperitoneal route with no added morbidity. RLDN requires lesser operative time with comparable morbidity.
authors.affiliation: Department of Urology, Manipal Hospital, Old Airport Road, Bangalore, Karnataka, India.
authors.forename: Shrinivas Rudrapatna
authors.initials: SR
authors.lastname: Pandarinath
authors.affiliation: Department of Urology, Manipal Hospital, Old Airport Road, Bangalore, Karnataka, India.
authors.forename: Babulal
authors.initials: B
authors.lastname: Choudhary
authors.affiliation: Department of Urology, Manipal Hospital, Old Airport Road, Bangalore, Karnataka, India.
authors.forename: Harvinder Singh
authors.initials: HS
authors.lastname: Chouhan
authors.affiliation: Department of Urology, Manipal Hospital, Old Airport Road, Bangalore, Karnataka, India.
authors.forename: Shivashankar
authors.initials: S
authors.lastname: Rudramani
authors.affiliation: Department of Urology, Manipal Hospital, Old Airport Road, Bangalore, Karnataka, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Dubey
keywords: Endo-stapler; IVC cuff; laparoscopic donor nephrectomy; right donor nephrectomy; transperitoneal nephrectomy
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