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Change in renal function after laparoscopic donor nephrectomy for kidney transplantation
C-H Chien1, H-H Wang, Y-J Chiang
1Graduate Institute of Clinical Medical Sciences, Department of Surgery, School of Nursing, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Transplantation Proceedings
|May 1, 2010
Summary
Laparoscopic donor nephrectomy (LDN) leads to increased kidney function in most living donors, particularly younger ones. However, older donors may require closer evaluation due to potential risks to renal function.
Area of Science:
- Nephrology
- Transplant Surgery
- Urology
Background:
- Laparoscopic donor nephrectomy (LDN) is the preferred method for living-donor kidney transplantation.
- Concerns exist regarding potential decreases in donor renal function and risk of end-stage renal failure post-LDN.
Purpose of the Study:
- To assess changes in renal function among living kidney donors following laparoscopic donor nephrectomy.
Main Methods:
- Evaluated 51 living kidney donors between March 2002 and December 2008.
- Measured 24-hour creatinine clearance (Ccr) and technetium 99m dimercaptosuccinic acid renal scan for initial kidney function.
- Monitored serum creatinine concentration (sCr) and Ccr postoperatively and at 3-month intervals.
Main Results:
- Mean sCr increased post-LDN (0.90 to 1.31), while Ccr of the remaining kidney increased by 36.9% (58.2 to 79.6).
- Younger donors and those with lower initial Ccr showed a greater functional increase.
- Most donors maintained adequate renal function, though 9.8% experienced a slight decrease at follow-up.
Conclusions:
- Younger donors and those with lower initial kidney function exhibit greater compensatory function post-nephrectomy.
- Donor age is a potential risk factor for diminished renal function after LDN.
- Older potential living donors warrant more thorough pre-donation renal function evaluation.
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