Abstract
Purpose: Concern has been raised about possible increased morbidity associated with laparoscopic donor nephrectomy (LDN) during the learning curve of the procedure and at centers with a low volume of living donors. We evaluated the safety and success of LDN at a low volume living donor transplant center with a skilled laparoscopic urologist and experienced renal transplant team. Materials and Methods: We reviewed the records of all patients who underwent LDN at our institution. A single surgeon skilled in laparoscopy (JAC) performed all LDNs. Patient demographics, operative reports, complications and recipient outcomes were evaluated. Results: A total of 17 LDNs were performed between January 2000 and September 2002. There was 1 elective conversion to an open procedure for kidney harvest due to complex hilar anatomy. Only 1 minor complication occurred (wound seroma) and 1 donor had creatinine persistently elevated to 1.9 mg/dl (normal 0.6 to 1.2). Mean operating room time, estimated blood loss and hospital stay were 250 minutes, 188 ml and 2.5 days, respectively. Recipient creatinine had a nadir mean of 1.2 mg/dl and a 90-day postoperative mean of 1.6 mg/dl. One recipient eventually lost the graft due to recurrent disease. Conclusions: LDN can be performed safely and efficiently at low volume transplant centers with a skilled laparoscopist and experienced renal transplant team. Laparoscopic skills developed during similar procedures, such as laparoscopic radical and partial nephrectomy, minimize the learning curve and morbidity of LDN to produce results consistent with those in the published literature.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 731-733 |
| Number of pages | 3 |
| Journal | Journal of Urology |
| Volume | 170 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 1 2003 |
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Keywords
- Kidney
- Kidney transplantation
- Laparoscopy
- Morbidity
- Nephrectomy
ASJC Scopus subject areas
- Urology
Cite this
Laparoscopic donor nephrectomy at a low volume living donor transplant center : Successful outcomes can be expected. / Duchene, David A.; Johnson, D. Brooke; Li, Shujun; Roden, Jay S.; Sagalowsky, Arthur I; Cadeddu, Jeffrey A.
In: Journal of Urology, Vol. 170, No. 3, 01.09.2003, p. 731-733.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic donor nephrectomy at a low volume living donor transplant center
T2 - Successful outcomes can be expected
AU - Duchene, David A.
AU - Johnson, D. Brooke
AU - Li, Shujun
AU - Roden, Jay S.
AU - Sagalowsky, Arthur I
AU - Cadeddu, Jeffrey A
PY - 2003/9/1
Y1 - 2003/9/1
N2 - Purpose: Concern has been raised about possible increased morbidity associated with laparoscopic donor nephrectomy (LDN) during the learning curve of the procedure and at centers with a low volume of living donors. We evaluated the safety and success of LDN at a low volume living donor transplant center with a skilled laparoscopic urologist and experienced renal transplant team. Materials and Methods: We reviewed the records of all patients who underwent LDN at our institution. A single surgeon skilled in laparoscopy (JAC) performed all LDNs. Patient demographics, operative reports, complications and recipient outcomes were evaluated. Results: A total of 17 LDNs were performed between January 2000 and September 2002. There was 1 elective conversion to an open procedure for kidney harvest due to complex hilar anatomy. Only 1 minor complication occurred (wound seroma) and 1 donor had creatinine persistently elevated to 1.9 mg/dl (normal 0.6 to 1.2). Mean operating room time, estimated blood loss and hospital stay were 250 minutes, 188 ml and 2.5 days, respectively. Recipient creatinine had a nadir mean of 1.2 mg/dl and a 90-day postoperative mean of 1.6 mg/dl. One recipient eventually lost the graft due to recurrent disease. Conclusions: LDN can be performed safely and efficiently at low volume transplant centers with a skilled laparoscopist and experienced renal transplant team. Laparoscopic skills developed during similar procedures, such as laparoscopic radical and partial nephrectomy, minimize the learning curve and morbidity of LDN to produce results consistent with those in the published literature.
AB - Purpose: Concern has been raised about possible increased morbidity associated with laparoscopic donor nephrectomy (LDN) during the learning curve of the procedure and at centers with a low volume of living donors. We evaluated the safety and success of LDN at a low volume living donor transplant center with a skilled laparoscopic urologist and experienced renal transplant team. Materials and Methods: We reviewed the records of all patients who underwent LDN at our institution. A single surgeon skilled in laparoscopy (JAC) performed all LDNs. Patient demographics, operative reports, complications and recipient outcomes were evaluated. Results: A total of 17 LDNs were performed between January 2000 and September 2002. There was 1 elective conversion to an open procedure for kidney harvest due to complex hilar anatomy. Only 1 minor complication occurred (wound seroma) and 1 donor had creatinine persistently elevated to 1.9 mg/dl (normal 0.6 to 1.2). Mean operating room time, estimated blood loss and hospital stay were 250 minutes, 188 ml and 2.5 days, respectively. Recipient creatinine had a nadir mean of 1.2 mg/dl and a 90-day postoperative mean of 1.6 mg/dl. One recipient eventually lost the graft due to recurrent disease. Conclusions: LDN can be performed safely and efficiently at low volume transplant centers with a skilled laparoscopist and experienced renal transplant team. Laparoscopic skills developed during similar procedures, such as laparoscopic radical and partial nephrectomy, minimize the learning curve and morbidity of LDN to produce results consistent with those in the published literature.
KW - Kidney
KW - Kidney transplantation
KW - Laparoscopy
KW - Morbidity
KW - Nephrectomy
UR - http://www.scopus.com/inward/record.url?scp=0042237790&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0042237790&partnerID=8YFLogxK
U2 - 10.1097/01.ju.0000081648.65198.2d
DO - 10.1097/01.ju.0000081648.65198.2d
M3 - Article
C2 - 12913684
AN - SCOPUS:0042237790
VL - 170
SP - 731
EP - 733
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 3
ER -