Laparoscopic donor nephrectomy (LDN) has been adopted rapidly as it offers less postoperative pain, early recovery, and better cosmetic results compared to the open approach. This prospective study investigates the results of the first 50 LDN performed between May 2005 and May 2006, with regards to:
(1) donor morbidity
(2) effect on graft function.
LDN was attempted in 50 donors by the same surgical team. Donors were 43 males, 7 females, aged 22 to 51 years old, with body mass index of 17.9 to 42.4. Left nephrectomy was planned in 46 donors and right nephrectomy in 4 donors according to the CT angiography findings. LDN was successfully performed in 44 cases (88%), converted to open technique in 6 donors (12%), secondary to technical difficulties in 3, and operative bleeding in 3 donors. The mean operating time for the fully LDN cases was 186.94 min (range 95 to 260 min), and mean warm ischemia time (WIT) of 5.7 (range 2-16 min). Mean hospital stay was 5.7 days (range 3-14 days). Two donors (4.5%) were re-explored for postoperative bleeding. At 3 months follow up, renal function of all donors was satisfactory. There was immediate diuresis in 41 recipients and delayed in 3 recipients. Acute cellular rejection was defined in one recipient. No association was found between WIT, graft function, development of ATN or rejection. There was clear association between the plasma creatinine normalization and the donor age. In this small series LDN was found to be a safe procedure with low post operative morbidity and short recovery time for the donor. These findings address some of the concerns surrounding LDN and support its potential to increase the living donor pool.