Evaluating graft function in pediatric recipients for living donor renal transplantation: Is laparoscopic donor...

To evaluate the surgical and functional outcomes of laparoscopic graft procurement in pediatric patients undergoing renal transplantation.

A retrospective chart review of the cohort records of 54 pediatric living donor renal transplant recipients from 1985 through June 2006 was performed. We compared results of laparoscopic donor nephrectomy (LDN, n = 15) and open donor nephrectomy (ODN, n = 39). Parameters analysed included donor technique and morbidity, operative complications, immediate postoperative renal function, the incidence of early and delayed graft function, and long-term graft survival.

The mean age of these recipients was 14.8 years (5-18) in the LDN group and 13.9 years (8-18) in ODN group. Serum creatinine (mg/dl) was 1.5 +/- 0.7 vs 1.8 +/- 1.3 at day 1 (P = 0.20), 1.0 +/- 0.3 vs 1.4 +/- 1.3 at day 2 (P = 0.12), 1.1 +/- 0.9 vs 1.3 +/- 1.0 at day 7 (P = 0.25), 1.2 +/- 0.5 vs 1.6 +/- 1.8 (P = 0.20) at day 14, 1.1 +/- 0.7 vs 1.2 +/- 1.4 (P = 0.39) at 1 month in LDN vs ODN groups, respectively. Early graft function was 35.7 vs 46.4% in the respective groups. There were two delayed graft function and one graft nonfunction in ODN group. Over all graft and patient survival at 1 year was 86.67 and 82.22% (P = 0.34) in LDN and ODN groups, respectively.

Pediatric recipients of the LDN grafts have outcomes comparable to those of ODN graft recipients. Laparoscopic donor nephrectomy is safe and efficacious for graft procurement for pediatric recipients.