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Updated: May 26, 2026
07:30
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Intraoperative hyperkaliemia complicating hand-assisted live-donor nephrectomy
David van Dellen1, Afshin Tavakoli, Richard Wadsworth
1Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary, Manchester, United Kingdom.
Summary
Live kidney donation using hand-assisted laparoscopy is valuable, but hyperkalemia can signal rhabdomyolysis from muscle injury. Vigilance is crucial, especially in muscular donors, to protect the remaining kidney.
Area of Science:
- Nephrology
- Surgical Innovation
- Transplant Surgery
Background:
- Live kidney donation is vital for transplant recipients.
- Hand-assisted laparoscopic donor nephrectomy is a key procurement method.
- Careful planning minimizes donor risks and ensures graft quality.
Observation:
- A case of live kidney donation via hand-assisted laparoscopy is presented.
- The donor experienced profound intraoperative hyperkalemia.
- This was later attributed to rhabdomyolysis from muscle necrosis.
Findings:
- A 46-year-old donor developed unexplained hyperkalemia during surgery.
- Postoperatively, elevated creatine kinase and gluteal bruising indicated rhabdomyolysis.
- The hyperkalemia resolved with fluid resuscitation and diuresis.
- Rhabdomyolysis was linked to prolonged positioning during surgery.
Implications:
- Hyperkalemia during laparoscopic renal surgery may indicate rhabdomyolysis.
- Prompt recognition and treatment of rhabdomyolysis are essential.
- Increased vigilance is needed for donors with higher muscle mass to protect their solitary kidney.
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