Retroperitoneal laparoscopic nephrectomy of native kidneys in renal transplant recipients

The purpose of this study was to compare retroperitoneal laparoscopic nephrectomy in transplant recipients and in other patients scheduled for nephrectomy.

From February 1994 to July 1996, 15 transplant recipients and 17 other patients underwent a total of 36 retroperitoneal laparoscopic nephrectomies for various indications. Operative time, morbidity, and hospital stay were compared between the two groups.

The average operating time for the 36 procedures was 95+/-38 min (range, 35-180 min). It was shorter in transplant recipients (81+/-32 min) than in other patients (100+/-39 min, P<0.05). There was one postoperative complication in the transplant recipient group. The average length of the postoperative hospitalization was 3.7+/-1.4 days (range, 2-8 days).

The retroperitoneal laparoscopic approach for nephrectomy is as safe and effective in renal transplant recipients as in other patients. Postoperative stay and delay to resumption of oral immunotherapy are short. This approach has become our first-line approach for native nephrectomy in transplant recipients.