[Postoperative course after open nephrectomy for organ donation]

To evaluate the quality of the postoperative course after conventional organ donation nephrectomy.

Over the last 29 months, 29 organ donation nephrectomies were performed in our hospital. Thirteen donors were non-residents. This series consisted of twenty organ donations between siblings, two organ donations from children to parents and seven organ donations from parents to children. The mean age of the donors was 42 years (range: 21 to 53). Ten pairs were HLA identical, 18 were semi-identical and one pair had only one A identity in common. The mean plasma creatinine on admission was 81 +/- 23 mumol/l.

Twenty three left kidneys and 3 right kidneys were harvested, with the last two right kidneys removed via a right anterior subcostal incision. Among the 23 left lumbotomies, the 11th rib was preserved in 21 cases in order to decrease postoperative pain. The mean operating time for patients operated by lumbotomy was 90 +/- 11 minutes. The mean postoperative stay (MPS) was 4.56 days (range: 3 to 8 days). The mean morphine consumption during hospitalisation was 40 mg per patient (range: 0 to 105 mg). Only one complication was observed: pneumothorax requiring postoperative drainage for 48 hours with no subsequent sequelae. No donor was transfused intraoperatively or postoperatively and no wound sequelae were observed. The mean plasma creatinine on discharge was 113 +/- 23 mumol/l.

These results in terms of analgesic consumption, complications, and mean postoperative stay appear to compare favourably with those obtained by other teams, particularly when organ harvesting is performed laparoscopically (MPS: 4.5 days vs 3 days).