This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (62)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Endocrine Surgery  • Kidney Transplantation  • Alert me on articles by topic

Truman M. Sasaki, MD; Frederick Finelli, MD; Elizabeth Bugarin, MD; Deneen Fowlkes, BS; Julie Trollinger, PA-C; Diana Young Barhyte, PhD, RN; Jimmy A. Light, MD

Arch Surg. 2000;135:943-947.

Hypothesis  The posttransplantation renal function outcomes between consecutive open donor and laparoscopic donor nephrectomies (LDNs) are similar and affect living donation.

Design  Using the medical records of renal living donor–recipient pairs, 36 consecutive open donor nephrectomies were compared with the subsequent 100 LDNs. Data collected on donor characteristics included demographics (age, race, sex, weight, and height), renal vascular and ureteral anatomical features, surgical information (blood loss, number of blood transfusions, operating time, warm ischemia time, and renal injury), complications, and length of hospital stay. Recipients' data also included renal function information (serum creatinine level on postoperative days 7 and 30) and ureteral complications during the initial hospital stay.

Setting  A not-for-profit tertiary care teaching hospital in a metropolitan area.

Patients  Adults who had end-stage renal disease and received a living donation kidney.

Main Outcome Measures  Operative time, warm ischemia time, blood loss, and posttransplantation serum creatinine level.

Results  Patient characteristics were not significantly different between the open donor nephrectomy and LDN groups. No right kidney LDNs were done because of the shortness of the right renal vein; and, after the initial experience, left kidneys with more than 2 arteries were excluded. Warm ischemia time was recorded only for LDN, and it was found that a warm ischemia time of 10 minutes or longer was associated with difficulty in extraction and was uniformly associated with elevated mean serum creatinine levels on postoperative day 7.

Conclusions  The length of hospital stay was decreased and cosmetic result enhanced. The number of living donors has increased from 28 in 1997 to 53 in 1998 and to 63 in 1999 at our institution. The length of hospital stay, incidence of complications, and comparable kidney quality indicate that LDN should be the initiating procedure for most patients.

From the Transplantation Services, Washington Hospital Center (Drs Sasaki, Finelli, Bugarin, and Light and Ms Trollinger), and MedStar Research Institute (Ms Fowlkes and Dr Barhyte), Washington, DC.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Multi-Detector Row CT in Evaluation of 94 Living Renal Donors by Readers with Varied Experience
Sahani et al.
Radiology 2005;235:905-910.
ABSTRACT | FULL TEXT  

Multi-Detector Row CT Evaluation of Living Renal Donors Prior to Laparoscopic Nephrectomy
Kawamoto et al.
RadioGraphics 2004;24:453-466.
ABSTRACT | FULL TEXT  

Multidetector CT Angiography for Preoperative Evaluation of Living Laparoscopic Kidney Donors
Kawamoto et al.
Am. J. Roentgenol. 2003;180:1633-1638.
ABSTRACT | FULL TEXT  

MR Angiography and Preoperative Evaluation for Laparoscopic Donor Nephrectomy
Jha et al.
Am. J. Roentgenol. 2002;178:1489-1495.
ABSTRACT | FULL TEXT  

Evaluation of Prospective Living Renal Donors for Laparoscopic Nephrectomy with Multisection CT: The Marriage of Minimally Invasive Imaging with Minimally Invasive Surgery
Rydberg et al.
RadioGraphics 2001;21:S223-236.
ABSTRACT | FULL TEXT  

Increased Transplantation of Kidneys With Multiple Renal Arteries in the Laparoscopic Live Donor Nephrectomy Era: Surgical Technique and Surgical and Nonsurgical Donor and Recipient Outcomes
Troppmann et al.
Arch Surg 2001;136:897-907.
ABSTRACT | FULL TEXT