Understanding Decision Making and Post-Donation Experiences for Robotic Single Port and Laparoscopic Donor...

Understanding decision-making and post-donation experiences in living kidney donors informs more effective pre-donation counseling and follow-up care. This study examined factors influencing donation decisions and post-operative experiences among patients who underwent laparoscopic donor nephrectomy (LDN) or single port robotic-assisted donor nephrectomy (SPRDN).

We conducted a retrospective survey of patients who underwent LDN or SPRDN by a single surgeon between 2013 and 2024 using a study-specific questionnaire. Participants rated pre-donation factors based on importance in their decision to donate. Responses were analyzed based on donor age, sex and relationship to recipient. Donors then reported on their post-donation experiences, and responses were analyzed by surgical approach.

Sixty-eight patients completed the survey (44% response rate). Donors rated long-term renal function and personal fulfillment as the most important factors when deciding to donate. Additionally, female donors prioritized personal fulfillment significantly more than male donors and younger donors were significantly more concerned about post-operative complications and recovery than older donors. After donation, most donors reported increased happiness and minimal quality-of-life impact, though nearly half expressed greater caution in daily activities. Notably, SPRDN donors were significantly more likely to report faster-than-expected recovery compared to LDN donors.

Donors prioritize long-term kidney health and personal fulfillment when considering donation, underscoring the need to address these concerns during preoperative counseling. Following donation, ongoing lifestyle education is essential to address persistent post-donation caution and ensure long-term donor well-being. SPRDN is as a promising alternative for LKD, potentially enhancing the donor experience through faster recovery.