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Complications and risks of living donor nephrectomy
E M Johnson1, M J Remucal, K J Gillingham
1Department of Surgery, University of Minnesota, Minneapolis 55455, USA.
Transplantation
|November 14, 1997
Summary
Living donor nephrectomy has low major complication rates (0.2%), but risks exist. Donor nephrectomy outcomes must be weighed against improved recipient survival in kidney transplantation.
Area of Science:
- Nephrology
- Transplantation Surgery
- Surgical Outcomes
Background:
- Living donor kidney transplants offer superior patient and graft survival compared to cadaveric transplants.
- Donor nephrectomy, while essential, carries inherent risks of morbidity and mortality.
- Previous estimates placed living donor nephrectomy mortality at 0.03%.
Purpose of the Study:
- To determine the perioperative morbidity associated with living donor nephrectomy.
- To identify risk factors for complications and prolonged postoperative stay.
Main Methods:
- Retrospective review of 871 donor nephrectomies performed between January 1, 1985, and December 31, 1995.
- Data collected included donor demographics, operative details, and postoperative outcomes.
- Logistic regression analysis was used to identify risk factors.
Main Results:
- Two major complications (0.2%) and 86 minor complications (8%) were recorded.
- Significant risk factors for complications included male gender, pleural entry, and weight ≥ 100 kg.
- Operative duration ≥ 4 hours and age ≥ 50 years were linked to longer postoperative stays.
Conclusions:
- Living donor nephrectomy can be performed with minimal major morbidity.
- The benefits of improved recipient outcomes must be carefully balanced against the risks of nephrectomy.