Successful laparoscopic living donor nephrectomy: first experience in Lithuania

Area of Science:

• Nephrology
• Minimally Invasive Surgery
• Transplantation

Background:

• Laparoscopic living donor nephrectomy (LLDN) is an increasingly adopted technique for kidney donation.
• High-volume university centers offer a unique environment for evaluating novel surgical approaches.

Purpose of the Study:

• To report the initial outcomes of LLDN performed at a high-volume university center.
• To assess the safety and feasibility of LLDN in donors with prior abdominal surgery.

Main Methods:

• Four LLDNs were performed using a transperitoneal approach with suprapubic extraction.
• Donors and recipients were prospectively followed for six months, collecting clinical, laboratory, and surgical data.
• Informed consent was obtained from all participants.

Main Results:

• Four donors (1 male, 3 female, mean age 58) underwent LLDN; two had prior cholecystectomy.
• No intraoperative complications occurred. Mean surgery duration was 223.75 min, cold ischemia 77.5 min, and warm ischemia 6.37 min.
• Postoperative complications included one donor acute kidney injury and prolonged pain; one recipient experienced acute rejection. No delayed graft function was observed.

Conclusions:

• LLDN is a technically feasible and safe procedure in experienced hands.
• The learning curve for LLDN appears manageable in high-volume centers with existing laparoscopic nephrectomy expertise.
• LLDN can be successfully performed in donors with previous abdominal surgeries.