Living donor renal transplantation has become common worldwide. However, living donor nephrectomy is not a complication free procedure. This retrospective study reviews the peri- and post-operative risks and complications of donor nephrectomies at our institution between 1994 and 2002. 257 consecutive donor nephrectomy patients were evaluated from their medical records and anesthetic charts.
One hundred and forty three female and 114 male aged between 19 and 73 years (mean 42 ±12 yr) were included. Anesthesia for donor nephrectomie included general anesthesia (n=215, 83.6%), combined spinal - epidural anesthesia (n=13, 5.1%) general + combined spinal - epidural anesthesia (n=28, 10.9%) and general + epidural anesthesia (n=1, 0.4%). Patients were operated on lateral decubitis position. Left and right-sided kidneys were taken in 96 (37.4%) and 161 (62.6%) cases respectively. Fourteen patient (5.4 %) developed hypotension intraoperatively. Duration of surgery was 3.56 ± 0.26hrs (range, 2-5 hrs). Serum creatinine levels increased significantly (p<0.05) on the postoperative 1st, 3rd and 5th days in comparison with the preoperative levels (p<0.05). Postoperative complications (n=12, 4.6%) were paresthesia at the incision site (n=5, 1.9%), incisional hernia (n=1, 0.4%), stitch infection (n=1, 0.4%), acute pangastritis (n=1, 0.4%), depression (n=1, 0.4%), postoperative bleeding (n=1, 0.4%), neck ache (n=1, 0.4%), and pulmonary thromboembolism (n=1, 0.4%). The donors were hospitalized for 4.7 ± 1.7 days (2-10 days). There was no mortality. Like other surgical operations, living donor nephrectomy is also associated with peri- and post-operative complications. Although these complications are minor, maximal efforts must be applied in the anesthetic approach to minimize donor complications, and donors should be informed about the potential risks.