title: Effect of Donor Nephrectomy Technique on Recipient Lymphatic Drainage.
abstract: OBJECTIVE
  We sought to evaluate the postoperative recipient lymphatic drainage depending on open donor nephrectomy (ODN) or laparoscopic (LDN) techniques.
  
  
  METHODS
  Between March 2012 and August 2014, 58 patients underwent renal transplantation from living-related donors. Thirty donors underwent ODN (group 1), and 28 LDN (group 2). Operations were performed by the same surgeons. Both cranial and caudal drainage catheters for lymphatic leakage were placed preoperatively and all the recipients received tacrolimus, mycophenolate mofetil, and steroid as immunosuppressive regimen. None of the patients had coagulation abnormalities.
  
  
  RESULTS
  All grafts were functioning during the early postoperative period and diuresis was ensured. No difference was observed on early postoperative period regarding to acute rejection (P = .329) or infection (P = .546). No difference was seen concerning mycophenolate mofetil and mycophenolate sodium regimens among the 2 groups (P = .227). In groups 1 and 2, the cranial drainage catheters were not taken out until postoperative days 5.5 ± 2.5 (range, 0-11) and 6.4 ± 3.8 (range, 0-14) and the caudal catheters stayed in place until days 8.8 ± 3.5 (range, 1-16) and 9.9 ± 5.9 (range, 3-22), respectively. No difference was found when comparing the cranial (P = .308) and caudal (P = .426) drainage periods. However, during clinical acute rejection episodes the cranial drainage period was longer in group 1 (P = .003). Three patients developed lymphoceles, 1 requiring drainage, in group 2.
  
  
  CONCLUSIONS
  There seems to be no difference in recipient lymphatic drainage by donor nephrectomy technique. A laparoscopic procedure may be advantageous owing to shorter lymphatic drainage during clinical acute rejection episodes.
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: tztefik@istanbul.edu.tr.
authors.forename: T
authors.initials: T
authors.lastname: Tefik
authors.affiliation: Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: H S
authors.initials: HS
authors.lastname: Ciftci
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Kocak
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Sanli
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Ander
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Ziylan
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Oktar
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Verep
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Caliskan
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Turkmen
authors.affiliation: Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: F S
authors.initials: FS
authors.lastname: Oguz
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Nane
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage / Q000706:statistics & numerical data*; D005260:Female; D006084:Graft Rejection / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D019520:Living Donors; D008210:Lymphocele / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011182:Postoperative Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000628:therapy; D020858:Tissue and Organ Harvesting / Q000379:methods*