Right Kidney Mini-Invasive Living Donor Nephrectomy: A Safe and Efficient Alternative

Area of Science:

• Nephrology
• Surgical Innovation
• Transplant Surgery

Background:

• Right kidney living donor transplantation presents unique challenges and potential complications.
• Evaluating the safety and efficacy of right-sided hand-assisted laparoscopic donor nephrectomy (R-HALDN) is crucial for donor well-being and graft success.

Purpose of the Study:

• To assess donor safety and graft function following right hand-assisted laparoscopic donor nephrectomy (R-HALDN).
• To compare outcomes of R-HALDN with left-sided nephrectomy (L-HALDN) in living kidney donors.

Main Methods:

• Retrospective analysis of 270 consecutive HALDN procedures performed up to April 2017.
• Comparison of outcomes between right-sided (R-HALDN) and left-sided (L-HALDN) nephrectomies.
• Evaluation of donor safety metrics and recipient graft function parameters.

Main Results:

• No conversions to open surgery or preoperative blood transfusions were required for R-HALDN.
• Operative times were similar between R-HALDN and L-HALDN (170 ± 37 min vs. 171 ± 32 min).
• Warm ischemia time was significantly longer for R-HALDN (4.0 ± 1.6 min vs. 3.0 ± 1.7 min; p < 0.001), with no significant differences in post-operative complications, serum creatinine, or graft survival.

Conclusions:

• Right hand-assisted laparoscopic donor nephrectomy (R-HALDN) is a safe procedure for kidney donors.
• R-HALDN demonstrates excellent graft function in recipients, comparable to L-HALDN.
• The findings support R-HALDN as a viable option for living kidney donation.