Retrospective Evaluation of the Effect of Laparoscopic and Conventional Donor Nephrectomy on Graft Functions

This study aims to compare conventional and laparoscopic living donor nephrectomy procedures performed in our hospital in terms of clinical and laboratory findings, morbidity, and mortality for donors and recipients.

Recipients were categorized into 2 groups according to the surgical approach taken to procure the graft transplanted to them. Variables that are compared include demographic information, number of mismatches, underlying pathology, length of hemodialysis, crossmatch results, nephrectomy side, side of the transplant, number of donor arteries/veins/ureters, preoperative /intraoperative /postoperative immunosuppression protocols, urea, creatine and glomerular filtration rate values at preoperative /postoperative /discharge times, first month and year creatine levels, hospital stay lengths, postoperative complication, rejection, and mortality rates.

In the recipient patient group, the warm and cold ischemia times of the grafts in the LDN group were found to be significantly longer than those in the ODN group (P < .001 and P = .002). The LDN group had higher complication rates compared to the ODN group (P = .004). In the donor group, hospital stay duration was shorter for patients who underwent LDN (P = .021). When examining graft rejection and function, chronic rejection was found to be higher in grafts with ODN (P = .004). Grafts with higher warm and cold ischemia times had worse 1-year creatinine change outcomes (P = .009, P = .013).

The LDN procedure increases the warm and cold ischemia times of the graft compared to ODN. However, it does not significantly affect graft survival and kidney function in long-term follow-ups.