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The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing
Quentin Franquet1, Xavier Matillon2, Nicolas Terrier1
1Department of Urology and Kidney Transplantation, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 9, France.
Insights
The Mayo Adhesive Probability (MAP) score can predict complications in living kidney donors undergoing laparoscopic nephrectomy. A high MAP score is linked to increased risks of intraoperative and postoperative issues, aiding donor evaluation.
Area of Science:
- Nephrology
- Surgical Oncology
- Medical Imaging
Background:
- Living donor nephrectomy is a critical procedure for healthy individuals.
- Accurate risk assessment and donor information are paramount.
Purpose of the Study:
- To evaluate the Mayo Adhesive Probability (MAP) score's utility in predicting complications during living donor nephrectomy.
- To assess the MAP score's role in improving donor information and outcomes.
Main Methods:
- Retrospective review of imaging, clinical, and follow-up data from 452 laparoscopic donor nephrectomies.
- Analysis of 307 donors with available data, categorizing them by MAP score (≥3 considered high).
- Multivariate analysis to determine the association between high MAP score and intra/postoperative complications.
Main Results:
- A high MAP score (≥3) was observed in 14% of donors.
- High MAP score significantly correlated with increased risk of intraoperative difficulties (OR 14.12) and conversion to open surgery (OR 18.96).
- High MAP score was also associated with a higher risk of postoperative complications (OR 2.55).
Conclusions:
- The MAP score is a valuable tool for predicting intraoperative and postoperative complications in living kidney donors.
- Implementing the MAP score in donor evaluation can enhance donor information and potentially improve surgical outcomes.
Purpose:
Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient's individualized risk and improve potential donors' information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy.
Materials And Methods:
We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers.
Results:
Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (n = 35) and bleeding (n = 17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58-35.7), p < 0.001] or conversion to open surgery [OR 18.96 (3.42-105.14), p = 0.0042]. Postoperative complications were noted in 99 patients (32%), including 12 patients (3.9%) with Clavien-Dindo grade III-IV complications. On multivariate analysis, a high MAP score was also associated with the risk of postoperative complications [OR 2.55 (1.20-5.40), p = 0.01].
Conclusions:
In this retrospective bicentric study, a high MAP score was associated with the risk of intra- and postoperative complications of laparoscopic donor nephrectomy. The MAP score appears of interest in the living donor evaluation process to help improve donors' information and outcomes.
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