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Updated: Mar 8, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Laparoscopic vs open donor nephrectomy: Lessons learnt from single academic center experience
Georgios Tsoulfas1, Polyxeni Agorastou1, Dicken S C Ko1
1Georgios Tsoulfas, Polyxeni Agorastou, Department of Surgery, Aristotle University of Thessaloniki, 54622 Thessaloniki, Greece.
Insights
Laparoscopic living donor nephrectomy (LLDN) offers comparable safety to open donor nephrectomy (OLDN) with a shorter hospital stay. Mastery of the learning curve significantly reduces operating time for LLDN.
Area of Science:
- Nephrology
- Surgical Innovation
- Transplantation Medicine
Background:
- Living donor nephrectomy is crucial for kidney transplantation.
- Both open donor nephrectomy (OLDN) and laparoscopic living donor nephrectomy (LLDN) are employed.
- Assessing long-term outcomes and procedural efficiency is vital.
Purpose of the Study:
- To compare the safety and efficacy of LLDN versus OLDN.
- To evaluate the impact of the learning curve on LLDN outcomes.
- To analyze donor and recipient outcomes over a decade.
Main Methods:
- Retrospective review of 490 living donor nephrectomies (279 LLDN, 211 OLDN) from 1998-2009.
- Analysis of demographic data, operative times, learning curve effects, and conversion rates.
- Comparison of preoperative and postoperative renal function (GFR, creatinine), graft function, and complication rates.
Main Results:
- No significant difference in operating time, renal function, or major complications between LLDN and OLDN initially.
- Significant reduction in operating time for LLDN after mastering the learning curve (last 100 cases).
- Shorter hospital stay observed for LLDN donors (2.87 days) compared to OLDN donors (3.6 days).
Conclusions:
- LLDN demonstrates a comparable safety profile to OLDN.
- The learning curve significantly impacts LLDN operative efficiency.
- LLDN offers a reduced length of stay for living kidney donors.
Aim:
To compare laparoscopic and open living donor nephrectomy, based on the results from a single center during a decade.
Methods:
This is a retrospective review of all living donor nephrectomies performed at the Massachusetts General Hospital, Harvard Medical School, Boston, between 1/1998 - 12/2009. Overall there were 490 living donors, with 279 undergoing laparoscopic living donor nephrectomy (LLDN) and 211 undergoing open donor nephrectomy (OLDN). Demographic data, operating room time, the effect of the learning curve, the number of conversions from laparoscopic to open surgery, donor preoperative glomerular filtration rate and creatinine (Cr), donor and recipient postoperative Cr, delayed graft function and donor complications were analyzed. Statistical analysis was performed.
Results:
Overall there was no statistically significant difference between the LLDN and the OLDN groups regarding operating time, donor preoperative renal function, donor and recipient postoperative kidney function, delayed graft function or the incidence of major complications. When the last 100 laparoscopic cases were analyzed, there was a statistically significant difference regarding operating time in favor of the LLDN, pointing out the importance of the learning curve. Furthermore, another significant difference between the two groups was the decreased length of stay for the LLDN (2.87 d for LLDN vs 3.6 d for OLDN).
Conclusion:
Recognizing the importance of the learning curve, this paper provides evidence that LLDN has a safety profile comparable to OLDN and decreased length of stay for the donor.
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