Complications After Hand-Assisted Laparoscopic Living Donor Nephrectomy

Area of Science:

• Nephrology
• Surgical Oncology
• Transplant Surgery

Background:

• Hand-assisted laparoscopic living donor nephrectomy (HALLDN) is a common procedure for kidney donation.
• Understanding post-discharge complications is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the incidence and nature of complications following HALLDN, with a specific focus on those arising after hospital discharge up to 120 days.
• To identify risk factors associated with these complications.

Main Methods:

• Retrospective analysis of 3002 HALLDN procedures performed at a single center from 2000 to 2019.
• Complications were classified using the Clavien-Dindo grading system.
• Statistical modeling was employed to determine risk factors for pre- and post-discharge complications.

Main Results:

• The overall complication rate was 12.4%, with 76% occurring after discharge.
• Major complications occurred in 2.5% of patients; no specific risk factors were identified for these.
• Risk factors for any complication included paramedian incision, prior abdominopelvic surgery, male sex, non-White race, and earlier surgical era.

Conclusions:

• A significant majority of HALLDN complications manifest after hospital discharge.
• Current literature may underestimate the true incidence of post-discharge complications.
• Enhanced post-discharge surveillance is recommended for patients undergoing HALLDN.