Early and late graft function after laparoscopic hand-assisted donor nephrectomy for living kidney transplantation: comparison with open donor nephrectomy.

摘要

BACKGROUND AND PURPOSE: Laparoscopic donor nephrectomy has become the procedure of choice for living kidney transplantation in many centers. We report on our experience with laparoscopic hand-assisted donor nephrectomy, in particular concerning graft function compared with open donor nephrectomy. MATERIALS AND METHODS: Between 1995 and March 2007, 72 patients with end-stage renal disease have received kidney transplantation from living donors. Open living donor nephrectomy (ODN) was performed in 35 donors, whereas 37 donors had undergone laparoscopic hand-assisted nephrectomy (HALDN). Immediate graft function, serum creatinine and serum cystatin C 1 year after the transplantation were evaluated. RESULTS: Median operative time was 138 min (113-180 min) in the HALDN group and 112 min (91-162 min) in the ODN group (p < 0.05). Warm ischemia time was 87 s (63-150 s) in the HALDN and 81 s (56-123 s) in the ODN groups, respectively (p = 0.13). Both the rate of primary graft function as well as kidney graft function parameters serum creatinine and serum cystatin C 1 year after transplantation showed no statistically significant difference between the two groups of patients. CONCLUSIONS: Laparoscopic hand-assisted donor nephrectomy is safe and has no negative impact on the transplanted graft function when compared with open donor nephrectomy.