Comparative analysis of donor and allograft outcomes based on laterality of kidney donation: proof of equivalence of the safety and efficacy of laparoscopic left versus right donor nephrectomy
Dinno Francis Mendiola1, Ernesto L. Gerial Jr.1, Jose Benito A. Abraham1.
1Urology, National Kidney and Transplant Institute, Quezon City, Philippines
Introduction and Objectives: Laparoscopic right donor nephrectomy is avoided by most urologists because of the shorter vein and its proximity to the inferior vena cava. We compared donor and recipient outcomes between laparoscopic left (LLDN) vs. right (LRDN) donor nephrectomy in a large volume transplant center in the Philippines.
Materials and Methods: A chart review was done on all laparoscopic donor nephrectomies performed from January 2011 to December 2015. Donor demographics (age, gender, BMI) intraoperative [operative time (OT), length of hospital stay (LOS), estimated blood loss (EBL) and warm ischemia time (WIT)] and postoperative outcomes [mean creatinine rise, delayed graft function (DGF)], complications and one-year allograft survival were compared between the two groups.
Results: A total of 441 donors, 397(89%) LLDN and 44(9%) LRDN were performed during the the study period. The donor characteristics were similar for both groups. There was no significant difference in OT in LLDN (178min[85-360]) vs. LRDN (176min[119-257]); EBL in LLDN (100mL[10-1600]) vs. LRDN (100mL[20-250]); LOS in LLDN (3days[2-8]) vs LRDN (3days[2-4]); WIT in LLDN (4min[1-32]) vs. LRDN (3min[1-12]) and DGF in LLDN 9/397(2.27%) and LRDN 2/44(4.55%). There was no signficant change in the mean donor and recipient creatinine up to one year. There was neither conversion to open nor mortality for both. The one-year allograft survival was also similar in LLDN 392/397(98.7%) vs. LRDN 42/44(95.4%).
Conclusion: Regardless of laterality, when performed by experienced hands, laparoscopic donor nephrectomy leads to equivalent outcomes for both donor and recipients in terms of safety profile and excellent allograft function.
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