Systemic heparinisation in laparoscopic live donor nephrectomy.

Area of Science:

• Nephrology
• Surgical Innovation
• Transplantation Immunology

Background:

• Systemic heparinization is standard practice during laparoscopic live donor nephrectomy (LDN) to prevent renal vascular thrombosis.
• The necessity and impact of heparin on outcomes in LDN remain subjects of investigation.

Purpose of the Study:

• To compare the outcomes of laparoscopic live donor nephrectomy with and without systemic heparin administration.
• To evaluate the safety and efficacy of omitting heparin in LDN.

Main Methods:

• A retrospective analysis of 186 consecutive LDN patients (April 2008–November 2012).
• Patients were divided into two groups: those who received systemic heparin (n=109) and those who did not (n=77).
• Outcome measures included donor/recipient complications, initial graft function, and 12-month graft survival.

Main Results:

• Demographics and warm ischemic times (WIT) were similar between heparinized and non-heparinized groups (WIT: 5 ± 3 minutes).
• No significant differences were observed in complication rates, graft thrombosis, primary non-function, or 12-month graft survival.
• Delayed graft function rates were comparable (3.6% vs. 1.2%, P=0.405).

Conclusions:

• Omitting systemic heparinization in laparoscopic live donor nephrectomy is a safe and feasible strategy.
• The absence of heparin does not compromise donor safety, recipient outcomes, or graft survival.