Laparoscopic vs open donor nephrectomy: Lessons learnt from single academic center experience.

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.