Laparoscopic Live Donor Nephrectomy: Experience of High-Volume Center with 2,477 Cases

Area of Science:

• Nephrology
• Transplant Surgery
• Minimally Invasive Surgery

Background:

• Living-donor kidney transplantation is crucial for addressing organ shortages.
• Laparoscopic live donor nephrectomy (LLDN) has become a standard procedure due to its benefits.
• Ensuring donor safety and optimizing outcomes are paramount in LLDN.

Purpose of the Study:

• To report outcomes and complication rates from the largest series of LLDN cases.
• To identify factors affecting operation time, ischemia time, and complications.
• To provide practical tips and tricks for surgeons performing LLDN.

Main Methods:

• Retrospective analysis of 2,477 LLDN cases between August 2012 and December 2019.
• Data collected included donor demographics, operative details (warm ischemia time, operation time), and complications.
• Statistical analysis was performed to identify significant factors.

Main Results:

• Female donors comprised 57.4% of the cohort.
• Right-sided LLDN and multiple renal arteries were associated with longer operation and warm ischemia times.
• Obesity (BMI >30 kg/m2) prolonged operation times and increased hospitalization and complication rates, but did not affect warm ischemia times.

Conclusions:

• LLDN is a reliable procedure with low complication rates and high donor satisfaction.
• Surgeons should consider kidney laterality and renal artery anatomy for optimized outcomes.
• Experience from a large case series provides valuable guidance for novice transplant surgeons.