Outcomes of transperitoneal laparoscopic living donor nephrectomy: a single-center study in Vietnam

(i) Describe renal vascular anatomy in Vietnamese donors with 256-slice MSCT; (ii) relate imaging to operative metrics and early outcomes of trans-peritoneal laparoscopic donor nephrectomy (LDN).

All consecutive living kidney donors who underwent trans-peritoneal LDN at Viet Duc University Hospital between January 2023 and June 2024 were prospectively enrolled. Eligibility required compliance with national donation criteria, informed consent, and complete clinical documentation. MSCT data (vessel number, length, diameter, variants) and surgical variables (trocar use, warm-ischemia time, blood loss, complications) were extracted from electronic records.

166 donors (41.6 ± 10.2 yr, 59% female) were analyzed. MSCT showed a single renal artery in 77.3% of kidneys and ≥ 2 arteries in 22.7%; multiple veins were more common on the right (14.7%). The left renal vein was far longer than the right (66.0 ± 14.0 vs 25.3 ± 7.4 mm, p < 0.001). Vessel number was predicted correctly in 95.8% of cases although pedicle length was over-estimated by 3-9 mm (p < 0.001). All nephrectomies were completed laparoscopically. Mean operative time was 118 ± 23 min; warm-ischemia time 4.5 ± 1.1 min; blood loss 70 ± 33 mL with no transfusions. Intra-operative morbidity was 4.2% (minor only) and 30-day morbidity 9.6%, almost entirely self-limited lymphatic leaks. Drains were removed after 3.5 ± 0.7 days; donors were discharged after 7.2 ± 2.0 days; creatinine fell from 110 to 92 µmol L⁻¹ within one month.

256-slice MSCT provides highly accurate vascular mapping that correlates closely with intra-operative findings. When combined with trans-peritoneal LDN, it yields short operative times, low complication rates, and rapid donor recovery, supporting its routine use in living donor programs in resource-constrained settings.