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Comparison of laparoscopic and open donor nephrectomy: a randomized controlled trial
Nasser Simforoosh1, Abbas Basiri, Ali Tabibi
1Department of Urology and Renal Transplantation, Urology and Nephrology Research Center, Shahid Labbafi Nejad Hospital, Shahid Beheshti University of Medical Science, 9th St., Pasdaran Ave, PO Box 1666679951, Tehran, Iran. simforoosh@iurtc.org.ir
BJU International
|March 30, 2005
Summary
Laparoscopic donor nephrectomy (LDN) offers better donor satisfaction and lower morbidity compared to open donor nephrectomy (ODN) in kidney transplantation, with similar graft outcomes. This approach enhances the donor experience while maintaining transplant success rates.
Area of Science:
- Nephrology
- Transplant Surgery
- Minimally Invasive Surgery
Background:
- Kidney transplantation is a vital treatment for end-stage renal disease.
- Donor nephrectomy, the surgical removal of a kidney from a donor, can be performed via open or laparoscopic techniques.
- Optimizing donor outcomes and satisfaction is crucial for successful transplantation programs.
Purpose of the Study:
- To compare graft survival, donor and recipient outcomes, donor satisfaction, and complications between laparoscopic donor nephrectomy (LDN) and open donor nephrectomy (ODN).
- To evaluate the efficacy and safety of a modified, cost-effective LDN procedure.
Main Methods:
- A randomized controlled trial involving 100 cases of LDN and 100 cases of ODN.
- Standard LDN procedure was modified to reduce costs.
- Outcomes assessed included operative duration, warm ischemia time, donor satisfaction scores, complication rates, graft function (serum creatinine), and long-term graft survival.
Main Results:
- LDN had a longer operative duration (270.8 min) and warm ischemia time (8.7 min) compared to ODN (152.2 min and 1.87 min, respectively).
- Donor satisfaction scores were significantly higher in the LDN group (19.6) versus the ODN group (17.3).
- Ureteric complications were absent in LDN, compared to 2% in ODN. Graft function and long-term graft survival (93.8% for LDN vs. 92.7% for ODN) were equivalent between groups. One LDN required conversion to ODN due to bleeding.
Conclusions:
- Laparoscopic donor nephrectomy (LDN) is associated with superior donor satisfaction and reduced donor morbidity compared to open donor nephrectomy (ODN).
- LDN provides equivalent graft outcomes and long-term survival to ODN.
- The findings support LDN as a favorable option for kidney donors, balancing surgical outcomes with patient experience.