The safety of hem-o-lock clips at donor nephrectomies

Hem-o-lock (polymer) vascular clips have been used over a long period for vascular control at donor nephrectomies. With our study, safety of hem-o-lock clip use at donor nephrectomies (conventional donor nephrectomy, transabdominal donor nephrectomy and retroperitonoscopic donor nephrectomy) has been evaluated.

A total of 883 cases, consisting of conventional donor nephrectomy, transabdominal donor nephrectomy and retroperitonoscopic donor nephrectomy, performed between May 2006 and August 2009 were retrospectively evaluated. Of all cases, 803 were performed conventional donor nephrectomy, 85 were performed endoscopic donor nephrectomy. Five patients who had first undergone endoscopic donor nephrectomy had conversion operations.

Vascular control at renal pedicle were obtained either with hem-o-lock clip ot vascular clamps. Cases with conventional donor nephrectomy were divided into two subgroups. Group I: cases which had transfixation sutures with 5.0 prolene in order to prevent clip separation after hem-o-lock clip use; Group II: cases without transfixation sutures. Only hem-o-lock sutures were used at laparoskopic and retroperitonoscopic techniques. Large and X-large clip and were used for renal arteries and two X-large clips were used for renal vein.

The most ideal method for vascular control at donor nephrectomy is controversial. Use of transfixation and hem-o-lock clips at conventional donor nephrectomy may be an alternative method. However for all three methods and at both groups, none of the cases who had undergone nephrectomy had bleeding or donor loss caused by hem-o-lock clips at intraoperative, perioperative anf postoperative periods. For this reason, we believe that use of hem-o-lock clips is a safe and reliable method for vascular control at donor nephrectomies.