En-Bloc Kidney Procurement Significantly Reduces Organ Extraction Time

Different surgical techniques of kidney procurement exist, for example, simultaneous en-bloc and sequential nephrectomy. After warm dissection, cross-clamping of the large vessels and perfusion of the organs, the cold dissection and extraction of organs is done. During the extraction time, organs are cut off from blood supply and, despite the cold flush, are not adequately cooled, which can result in ischemic damage. We propose that en-bloc kidney procurement shortens extraction time. We analyzed 242 cases of kidney procurement in Germany between January 2017 and December 2023 from donations after brain death (DBD) and compared the influence of the surgical techniques (en-bloc and sequential nephrectomy) on the extraction time of the first retrieved kidney. Kidneys procured with the en-bloc technique had significantly lower extraction times (median 44 vs. 60 minutes; p < .001), which was further confirmed in the multivariate linear regression analysis with a shortening of extraction time by approximately 14 minutes. In conclusion, en-bloc kidney procurement significantly shortens the organ extraction time in DBD organ procurement.