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- Title
Trends in kidney transplantation and living donor nephrectomy in Germany: a total population analysis from 2006 to 2021.
- Authors
Zacharis, Aristeidis; Reimold, Philipp; Aksoy, Cem; Jung, Jonas; Martin, Thomas; Eisenmenger, Nicole; Thoduka, Smita George; Groeben, Christer; Huber, Johannes; Flegar, Luka
- Abstract
Purpose: To analyze recent trends of surgical access routes, length of hospital stay (LOS), and mortality in kidney transplantation (KT) and living donor nephrectomy (LDN) in Germany. Materials and methods: We studied the nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021. Results: There were a total of 35.898 KTs. In total, 9044 (25%) were living donor transplantations, while 26.854 (75%) were transplantations after donation after brain death (DBD). The share of open LDN decreased from 82% in 2006 to 22% in 2020 (− 4%/year; p < 0.001). The share of laparoscopic LDN increased from 18% in 2006 to 70% in 2020 (+ 3%/year; p < 0.001). The share of robotic LDN increased from 0% in 2006 to 8% in 2020 (+ 0.6%/year; p < 0.001). Robotic-assisted KT increased from 5 cases in 2016 to 13 procedures in 2019 (p = 0.2). LOS was shorter after living donor KT, i.e., 18 ± 12.1 days versus 21 ± 19.6 days for DBD renal transplantation (p < 0.001). Moreover, LOS differed for open versus laparoscopic versus robotic LDN (9 ± 3.1 vs. 8 ± 2.9 vs. 6 ± 2.6; p = 0.031). The overall in-hospital mortality was 0.16% (n = 5) after LDN, 0.47% (n = 42) after living donor KT and 1.8% (n = 475) after DBD KT. Conclusions: There is an increasing trend toward minimal-invasive LDN in recent years. Overall, in-hospital mortality was low after KT. However, 5 deceased healthy donors after LKD caution that the risks of this procedure should also be taken very seriously.
- Publication
World Journal of Urology, 2024, Vol 42, Issue 1, p1
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-023-04737-w