Abstract
Introduction
Laparoscopic donor nephrectomy has become the standard of care in many renal transplant centers. Many centers are reluctant to perform right laparoscopic donor nephrectomies, primarily due to concerns about transplanting a kidney with a short renal vein.
Methods
A retrospective review of 26 right and 24 left consecutive donor nephrectomies and their recipients was performed. Patient demographics, preoperative, perioperative, and postoperative data were recorded and compared.
Results
Patient demographics were similar between groups. Multiple vessels were encountered more frequently on the right side (10 vs. 3, p = 0.04) and the donated kidney had lesser preoperative function in the right group as determined by nuclear medicine imaging (46.5% vs. 49.4%, p < 0.001). Donor operating times were less in the right group (198 vs. 226 min, p = 0.016). There was no difference in implantation difficulty as demonstrated by similar operative and warm ischemia times. Complication rates were similar between both groups of donors and recipients.
Conclusions
Right laparoscopic donor nephrectomy requires less operating time than, and is associated with similar outcomes for donors and recipients as, left laparoscopic donor nephrectomy. Right laparoscopic donor nephrectomy may be preferable in general and should be considered when multiple renal vessels are present on the left side and/or when preoperative function of the left kidney is greater than the right.
Similar content being viewed by others
References
Brook NR, Nicholson ML (2003) Laparoscopic live donor nephrectomy. Br J Surg 90(11):1313–1314
Burgos J (2007) Is reluctance to right-sided laparoscopic living donor nephrectomy justified? Eur Urol 51(5):1171–1172
Del Pizzo JJ, Sklar GN, You-Cheong JW, Levin B, Krebs T, Jacobs SC (1999) Helical computerized tomography arteriography for evaluation of live renal donors undergoing laparoscopic nephrectomy. J Urol 162(1):31–34
Diner E, Radolinski B, Murdock J, Ghasemian SR (2006) Right laparoscopic donor nephrectomy: the Washington hospital center experience. Urology 68(6):1175–1177
Fisher PC, Montgomery JS, Johnston WK 3rd, Wolf JS Jr (2006) 200 consecutive hand assisted laparoscopic donor nephrectomies: evolution of operative technique and outcomes. J Urol 175(4):1439–1443
Handschin AE, Weber M, Demartines N, Clavien PA (2003) Laparoscopic donor nephrectomy. Br J Surg 90(11):1323–1332
Kay MD, Brook N, Kaushik M, Harper SJ, Bagul A, Nicholson ML (2006) Comparison of right and left laparoscopic live donor nephrectomy. BJU Int 98(4):843–844
Kim FJ, Ratner LE, Kavoussi LR (2000) Renal transplantation: laparoscopic live donor nephrectomy. Urol Clin North Am 27(4):777–785
Kok NF, Lind MY, Hansson BM, Pilzecker D, Mertens zur Borg IR, Knipscheer BC, Hazebroek EJ, Dooper IM, Weimar W, Hop WC, Adang EM, van der Wilt GJ, Bonjer HJ, van der Vliet JA, IJzermans JN (2006) Comparison of laparoscopic and mini incision open donor nephrectomy: single blind, randomised controlled clinical trial. BMJ 333(7561):221
Leventhal J, Kocak B, Salvalaggio PO, Koffron A, Baker T, Kaufman D, Fryer J, Abecassis M, Stuart F (2004) Laparoscopic donor nephrectomy 1997 to 2003: lessons learned with 500 cases at a single institution. Surgery 136(4):881–890
Lewis GR, Mulcahy K, Brook NR, Veitch PS, Nicholson ML (2004) A prospective study of the predictive power of spiral computed tomographic angiography for defining renal vascular anatomy before live-donor nephrectomy. BJU Int 94(7):1077–1081
Liu KL, Chiang YJ, Wu CT, Lai WJ, Wang HH, Chu SH (2006) Why we consistently use the left donor kidney in living related transplantation: initial experience of right laparoscopic donor nephrectomy and comparison with left nephrectomy. Transplant Proc 38(7):1977–1979
Morrissey PE, Monaco AP (2006) Living kidney donation: evolution and technical aspects of donor nephrectomy. Surg Clin North Am 86(5):1219–1235, vii
Novotny MJ (2001) Laparoscopic live donor nephrectomy. Urol Clin North Am 28(1):127–135
Posselt AM, Mahanty H, Kang SM, Stoller ML, Meng MV, Roberts JP, Freise CE (2004) Laparoscopic right donor nephrectomy: a large single-center experience. Transplantation 78(11):1665–1669
Ratner LE, Montgomery RA, Kavoussi LR (2001) Laparoscopic live donor nephrectomy. A review of the first 5 years. Urol Clin North Am 28(4):709–719
Su LM, Ratner LE, Montgomery RA, Jarrett TW, Trock BJ, Sinkov V, Bluebond-Langner R, Kavoussi LR (2004) Laparoscopic live donor nephrectomy: trends in donor and recipient morbidity following 381 consecutive cases. Ann Surg 240(2):358–363
Tooher RL, Rao MM, Scott DF, Wall DR, Francis DM, Bridgewater FH, Maddern GJ (2004) A systematic review of laparoscopic live-donor nephrectomy. Transplantation 78(3):404–414
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sawatzky, M., Altaf, A., Ellsmere, J. et al. Is right laparoscopic donor nephrectomy right?. Surg Endosc 23, 1321–1325 (2009). https://doi.org/10.1007/s00464-008-0158-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-008-0158-8