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- Title
Open versus Laparoscopic and Retroperitoneoscopic Live Donor Nephrectomy: The Recipient Outcome.
- Authors
Giannini, O.; Bachmann, A.; Wolff, T.; Eugster, T.; Gürke, L.; Langer, I.; Oerti, D.; Vogelbach, Hess; Stoffel, F.; Sulser, T.; Gasser, T.; Vögele, T.; Steiger, J. U.; Dickenmann, M.; Hess, P.
- Abstract
Objective: Laparoscopic- (LDN) and retroperitoneoscopic (RDN) donor nephrectomy have become favored procedures in living donor transplantation. They provide a benefit for the donor but only limited data are available about their impact on recipient's outcome. The aim of the study was to determine the impact of LDN and RDN compared with grafts harvested by open donor nephrectomy (ODN) on recipient outcome. Methods: Living donor transplantations performed between February 1998 and October 2003 were analyzed retrospectively. The recipient outcome was evaluated in terms of allograft function, incidence of rejections and of surgical complications rate 30 days after transplantation. Creatinine levels were measured 7, 30 and 90 days after transplantation. Results: 148 patients were analyzed (50ODN, 48LDN, 50RDN). No differences were noted in the surgical outcome and complications except of warm ischemia time that was higher in LDN (P = 0.0014 ODN vs LDN, NS ODN vs RDN and LDN vs RDN). The in-hospital stay was shorter in RDN patients (P = 0.02 ODN vs RDN, 0.05 LDN vs RDN, NS ODN vs LDN). Thirty days after transplantation the incidences of rejections were comparable between the three groups (P = NS). The incidence of delayed graft function was higher in the RDN group (P = 0.043 LDN vs RDN, 0.039 ODN vs RDN). No statistically significant difference was found in creatinine levels at 1 (ODN 136 ± 49, LDN 124 ± 37, RDN 139 ± 49µmol/l) and 3 months (ODN 154 ± 62, LDN 154 ± 99, RDN 158 ± 52µmol/l) after transplantation. Conclusions: Minimally invasive nephrectomy has no negative impact on recipient's outcome. The minimally invasive techniques provide a benefit for the donor, are safe for the recipient and are therefore the method of choice. These new minimal invasive approaches could make living donor transplantation more attractive which is desirable in times of organ shortage.
- Subjects
CREATININE; ISCHEMIA; CREATINE; HETEROCYCLIC compounds; TRANSPLANTATION of organs, tissues, etc.
- Publication
Kidney & Blood Pressure Research, 2004, Vol 27, Issue 5/6, p306
- ISSN
1420-4096
- Publication type
Article