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10 Jahre laparoskopische Lebendnierenspende

Von Rarität zu Routine

Ten years of laparoscopic living kidney donation

From an extravagant to a routine procedure

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Zusammenfassung

Die laparoskopische Lebendspendernephrektomie (LDN) wurde vor 10 Jahren erstmals durchgeführt. Heute wird sie in vielen amerikanischen Zentren routinemäßig praktiziert. In der vorliegenden Arbeit werden die verschiedenen Aspekte der LDN, deren Auswirkungen für Spender, Organ, Empfänger und Operateur evaluiert. Es folgt die Literaturrecherche und -vergleich zum Thema laparoskopische Donornephrektomie und zu den verschiedenen Teilaspekten werden die Besonderheiten dieser Methoden und die eigenen Erfahrungen am aktuell größten deutschen LDN-Zentrum Zentrum (Charité Berlin, Campus Mitte) dargestellt.

Die laparoskopische Nierenentnahme beim lebenden Spender bietet die gleiche Sicherheit wie der offene Eingriff. Gleichzeitig bietet sie multiple Vorteile für den Donor, wie verminderte Schmerzen und kürzere Rekonvaleszenz. Für das gespendete Organ und den Empfänger sind keine Nachteile durch die neue Technik zu erwarten, sofern einige intra- und perioperative Maßnahmen Anwendung finden. Technische Weiterentwicklungen bieten zudem dem Operateur ein mittlerweile breites Armentarium zur optimalen Durchführung der LDN.

Die LDN ist für den Spender, das Organ, den Empfänger und den Operateur sicher. Kernpunkt einer optimalen LDN ist eine ausreichende Erfahrung in laparoskopisch-operativen Techniken und laparoskopischen urologischen Operationen.

Abstract

Ten years ago the first laparoscopic living donor nephrectomy (LDN) was performed. Today, LDN is a routine operation in many US-American transplantation centers and an increasing number of centers in Europe are practicing LDN. In this article the different aspects of LDN for donor, kidney, recipient and operating surgeon are evaluated.

We performed a literature research concerning LDN and the different aspects. Our own experience, as the largest LDN center in Germany, is part of the evaluation.

Laparoscopic extraction of a kidney from a living donor is as safe for the donor as the open approach. At the same time, LDN offers multiple advantages like reduced pain and shorter convalescence. For the donated kidney and the recipient no disadvantages occur from the laparoscopic technique, as long as special intra- and perioperative demands are met. For the operating surgeon multiple developments have expanded the technical armentarium.

LDN is safe for donor, recipient and kidney. Central issue of an optimal LDN is sufficient experience with laparoscopic urological techniques.

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Authors and Affiliations

  1. Klinik für Urologie, Campus Mitte, Charité Universitätsmedizin, Berlin

    M. Giessing, T. F. Fuller, S. Deger, J. Roigas, M. Tüllmann, B. Winkelmann, D. Schnorr & S. A. Loening

  2. Klinik für Nephrologie, Campus Mitte, Charité Universitätsmedizin, Berlin

    L. Liefeldt & K. Budde

  3. Institut für Diagnostische Radiologie, Campus Mitte, Charité Universitätsmedizin, Berlin

    T. Fischer

  4. Klinik für Urologie, Campus Mitte, Charité Universitätsmedizin Berlin, Schumannstraße 20–21, 10098, Berlin

    M. Giessing

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  1. M. Giessing
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Correspondence to M. Giessing.

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Giessing, M., Fuller, T.F., Deger, S. et al. 10 Jahre laparoskopische Lebendnierenspende. Urologe 45, 46–52 (2006). https://doi.org/10.1007/s00120-005-0963-9

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