title: The safety of hand-assisted laparoscopic living donor nephrectomy: the Ohio State University experience with 1500 cases.
abstract: Hand-assisted laparoscopic donor (HALD) nephrectomy has been performed at our institution since December 1999. Through May 2014, a total of 1500 HALD procedures have been performed. We have evaluated the outcomes of HALD. The HALD procedure consists of a hand-port incision as well as two 12-mm ports. Mean donor age was 40.8 ± 10.8 yr, BMI was 27.9 ± 5.0, there were 541 males, 1271 Caucasians, and the left kidney was removed in 1236 patients. All procedures were successfully completed. Four donors (0.27%) were converted to an open technique due to bleeding. Four donors required blood transfusions. 53 donors (3.5%) were readmitted in the first month post-donation; almost half were due to gastrointestinal complaints. Six donors required reoperation; three for SBO and three for wound dehiscence. 27 patients (1.8%) developed incisional hernias. Seven donors (0.47%) developed bowel obstruction. All donors recovered well with a mean hospital stay after donation of 2.1 ± 0.3 d. All except one kidney were successfully implanted. Twenty-one recipients (1.4%) experienced DGF. Ureter complications occurred in 17 (1.1%) recipients. Early graft loss occurred in 13 patients (0.9%). In conclusion, HALD is a safe procedure for the donor with good recipient outcomes.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, The Ohio State University, Columbus, OH, USA.
authors.forename: Amer
authors.initials: A
authors.lastname: Rajab
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Pelletier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009820:Ohio; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D055815:Young Adult
keywords: hand-assisted; kidney; laparoscopic; life donor; outcomes