title: Laparoscopicvsopen donor nephrectomy: Lessons learnt from single academic center experience.
abstract: OBJECTIVE
  To compare laparoscopic and open living donor nephrectomy, based on the results from a single center during a decade.
  
  
  METHODS
  This is a retrospective review of all living donor nephrectomies performed at the Massachusetts General Hospital, Harvard Medical School, Boston, between 1/1998 - 12/2009. Overall there were 490 living donors, with 279 undergoing laparoscopic living donor nephrectomy (LLDN) and 211 undergoing open donor nephrectomy (OLDN). Demographic data, operating room time, the effect of the learning curve, the number of conversions from laparoscopic to open surgery, donor preoperative glomerular filtration rate and creatinine (Cr), donor and recipient postoperative Cr, delayed graft function and donor complications were analyzed. Statistical analysis was performed.
  
  
  RESULTS
  Overall there was no statistically significant difference between the LLDN and the OLDN groups regarding operating time, donor preoperative renal function, donor and recipient postoperative kidney function, delayed graft function or the incidence of major complications. When the last 100 laparoscopic cases were analyzed, there was a statistically significant difference regarding operating time in favor of the LLDN, pointing out the importance of the learning curve. Furthermore, another significant difference between the two groups was the decreased length of stay for the LLDN (2.87 d for LLDNvs3.6 d for OLDN).
  
  
  CONCLUSIONS
  Recognizing the importance of the learning curve, this paper provides evidence that LLDN has a safety profile comparable to OLDN and decreased length of stay for the donor.
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsoulfas
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Agorastou
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Dicken S C
authors.initials: DS
authors.lastname: Ko
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Martin
authors.initials: M
authors.lastname: Hertl
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Nahel
authors.initials: N
authors.lastname: Elias
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: A B
authors.initials: AB
authors.lastname: Cosimi
authors.affiliation: Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kawai
keywords: Complications; Laparoscopic donor nephrectomy; Living donor renal transplantation; Open donor nephrectomy; Renal graft function; Surgical technique