Laparoscopic right nephrectomy for live kidney donation: functional results

Laparoscopic live-donor nephrectomy has gained wide acceptance. However, the vast majority of surgeons perform left nephrectomies only, which may not always be in the best interest of the donor. Of 17 consecutive laparoscopic donor nephrectomies, 13 were done on the right side. The function of these grafts was compared with that of 17 kidneys previously procured by an open technique and with that of the four left laparoscopic grafts. Ischaemic damage was evaluated by post-operative nuclear scanning and urinary lysozyme, and graft function by creatinine and creatinine clearance. Results show that operating time was longer in the laparoscopic donors, but identical in right and left laparoscopic procurements. Ischaemic damage and function were similar, regardless of the side or the surgical technique. We can conclude that right laparoscopic donor nephrectomy is feasible and results in good graft function. Systematic harvesting from the left side may, therefore, not be justified.