Due to the shortage of organ donations and rising number of patients with terminal renal insufficiency, living kidney donation has become increasingly important during recent years. The laparoscopic live-donor nephrectomy (LLDN) is the alternative for the conventional open approach which may decrease the surgical trauma to the donor. The aim of this study was to report our experience with this technique. We reviewed demographic data, operation duration, hospital stay duration and post-operative complications in donors and recipients of 100 LLDNs performed in Shiraz transplant unit from August 2006 to July 2008. A retrospective analysis of chemical and biochemical data of recipients was also performed. 30 female and 70 male subjects with a mean age of 35.88 ± 12.21 years were operated during this period. The mean operative time for donor nephrectomy was 138.30 ± 31.92 (60 to 205) minutes and for recipients was 87.66 ± 11.79 (75 to 120 minutes), with mean warm ischemic time of 5.19 ± 1.76 (2 to 8) minutes. The donors’ median hospital stay was 28.34 ± 8.31 (24 to 72) hours. Five donor operations were converted to open nephrectomy because of uncontrolled bleeding or abnormal anatomy. There was no need for blood transfusions or reoperations in the donors. Median hospital stay for recipients was 9.44 ± 3.61 (5 to 22) days. BUN and Creatinine decreased from preoperative 10.46 ± 3.73 and 66.10 ± 25.16 to 1.39 ± 0.38 and 29.64 ± 8.83 mg/dl at discharge. Renal graft was rejected in 2 cases due to immunologic causes without response to any intervention. There was no vascular thrombosis in the transplanted kidneys. LLDN is a viable alternative to the standard open nephrectomy and will have a positive impact on the donor pool by minimizing disincentives to live donation. The results of our program were acceptable and this approach may be the procedure of choice in the future in our center.
Volume : 6
Issue : 4
Pages : 109
Shiraz Transplant Center, Namazi Hospital and Transplantation Research Center, Shiraz University of Medical Sciences, Shiraz, Iran