Complications after a 5-year experience with laparoscopic donor nephrectomy: the Indiana University experience

Area of Science:

• Nephrology
• Surgical Innovation
• Transplantation

Background:

• Laparoscopic donor nephrectomy (LDN) is increasingly the standard for living donor nephrectomy.
• Concerns exist regarding donor safety and recipient ureteral complications with LDN.
• This study reviews a 5-year experience with 253 LDN procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of laparoscopic donor nephrectomy (LDN).
• To assess complication rates for both living donors and kidney transplant recipients.
• To analyze graft function and survival post-LDN.

Main Methods:

• Retrospective chart review of 253 laparoscopic live donors.
• Comparison of recipient postoperative creatinine values up to 12 months.
• Analysis of graft function, survival, and complication rates.

Main Results:

• Overall complication rate was 10.3% (2.8% intraoperative, 7.5% postoperative), with most being minor.
• No intraoperative complications occurred in the right-sided donor group.
• Recipient outcomes included 11.2% slow graft function, 4.4% delayed graft function, and <1% ureteral stricture; 2% graft loss.

Conclusions:

• LDN exhibits low intraoperative and postoperative complication rates, predominantly minor.
• Right-sided LDN showed increased operative time and hospital stay but not complication rates.
• Overweight recipients (BMI > 25) had no significant difference in outcomes or complication rates.