The aim of this studt is to evaluate the pediatric kidney allograft and donor outcomes in kidney transplantations from open and laparoscopic donor nephrectomies (LDN).
From June 2000 to June 2004, 40 LDNs and 89 open laparoscopic donor nephrectomies (ODN) have been performed for recipients 16 years old or younger. Recipient and donor demographics and their hospital records were reviewed and LDN was compared with ODN. Median age of recipients in LDN and ODN groups were 13 and 12 years. Mean warm ischemic time (WIT) were 8.43+-3.13 and 2.37+-1.70 minutes, respectively. Graft loss occurred in 2 and 3 recipients of LDN and ODN groups within the first year (p=NS). Median serum creatinine levels (mg/dl) in LDN were significantly higher up to the third month (p<0.05), but not from then up to the third year. However, creatinine clearance (CrCl) at days 1, 3, and 7 and months 3, 6, 24, and 36 were not statistically different. Median CrCl for three LDN goups regarding <6, 6-10, and >10 minutes were not significantly different at any time. WIT and operative time in LDN did not affect graft survival and WIT was not correlated with CrCl or serum creatinine level. One- and 2-year graft survivals for ODN were 96.1% and 88.4%, while it was 93.6% and 93.6 in LDN, respectively (p=NS). No conversion to open surgery occurred and reoeperation was not required in any of LDNs. Immunosuppressive regimen was similar both groups.
Laparoscopic adult donor nephrectomy seems to be a safe approach even for young recipients, with no serious complication or unaccepable graft survival rate.