Abstract
“Laparoscopic donor nephrectomy is a unique surgical procedure due to the fact that the surgeon is operating on a healthy individual in order to benefit another patient he or she is unlikely managing, with a potential for complications ensuing in both the donor and the recipient patients. Overall surgical technique, anatomic considerations, and perioperative management remain important for minimizing the donor’s morbidity. In addition, maneuvers to maximize graft function for the recipient must be performed without compromising the donor patient. This includes minimizing warm ischemia time, ensuring a safe graft retrieval, and performing a careful dissection of the renal hilum and ureter to maximize graft length for implantation. Lastly, the long-term medical consequences of loss of renal function for the donor must be considered.”
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References
Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146:278–82.
Ratner LE, Ciseck LJ, Moore RG, et al. Laparoscopic live donor nephrectomy. Transplantation. 1995;60:1047–9.
Ratner LE, Montgomery RA, Kavoussi LR. Laparoscopic live donor nephrectomy. A review of the first 5 years. Urol Clin North Am. 2001;28:709–19.
Duchene DA, Winfield HN. Laparoscopic donor nephrectomy. Urol Clin North Am. 2008;35:415–24, viii.
Shokeir AA. Open versus laparoscopic live donor nephrectomy: a focus on the safety of donors and the need for a donor registry. J Urol. 2007;178:1860–6.
Nanidis TG, Antcliffe D, Kokkinos C, et al. Laparoscopic versus open live donor nephrectomy in renal transplantation: a meta-analysis. Ann Surg. 2008;247:58–70.
Perry KT, Freedland SJ, Hu JC, et al. Quality of life, pain and return to normal activities following laparoscopic donor nephrectomy versus open mini-incision donor nephrectomy. J Urol. 2003;169:2018–2021.
Glannon W. Underestimating the risk in living kidney donation. J Med Ethics. 2008;34:127–8.
Giessing M, Turk I, Roigas J, et al. Laparoscopy for living donor nephrectomy – particularities of the currently applied techniques. Transpl Int. 2005;18:1019–27.
Schlunt LB, Harper JD, Broome DR, et al. Improved detection of renal vascular anatomy using multidetector CT angiography: Is 100% detection possible? J Endourol. 2007;21:12–7.
Bhatti AA, Chugtai A, Haslam P, et al. Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors. BJU Int. 2005;96:1105–8.
Hsu TH, Su LM, Ratner LE, et al. Impact of renal artery multiplicity on outcomes of renal donors and recipients in laparoscopic donor nephrectomy. Urology 61: 323–327, 2003.
Buell JF, Edye M, Johnson M, et al. Are concerns over right laparoscopic donor nephrectomy unwarranted? Ann Surg. 2001;233:645–51.
Wright AD, Will TA, Holt DR, et al. Laparoscopic living donor nephrectomy: a look at current trends and practice patterns at major transplant centers across the United States. J Urol. 2008;179:1488–92.
Jacobs SC, Cho E, Dunkin BJ, et al. Laparoscopic live donor nephrectomy: the University of Maryland 3-year experience. J Urol. 2000;164:1494–9.
Jacobs SC, Cho E, Foster C, et al. Laparoscopic donor nephrectomy: the University of Maryland 6-year experience. J Urol. 2004;171:47–51.
Ng CS, Abreu SC, Abou El-Fettouh HI, et al. Right retroperitoneal versus left transperitoneal laparoscopic live donor nephrectomy. Urology. 2004;63:857–61.
Su LM, Ratner LE, Montgomery RA, et al. Laparoscopic live donor nephrectomy: trends in donor and recipient morbidity following 381 consecutive cases. Ann Surg. 2004;240:358–63.
Leventhal JR, Kocak B, Salvalaggio PR, et al. Laparoscopic donor nephrectomy 1997 to 2003: lessons learned with 500 cases at a single institution. Surgery. 2004;136:881–90.
Kocak B, Koffron AJ, Baker TB, et al. Proposed classification of complications after live donor nephrectomy. Urology. 2006;67:927–31.
Melcher ML, Carter JT, Posselt A, et al. More than 500 consecutive laparoscopic donor nephrectomies without conversion or repeated surgery. Arch Surg. 2005;140:835–9; discussion 839–40.
Sundaram CP, Martin GL, Guise A, et al. Complications after a 5-year experience with laparoscopic donor nephrectomy: the Indiana University experience. Surg Endosc. 2007; 21:724–8.
Breda A, Bui MH, Liao JC, et al. Association of bowel rest and ketorolac analgesia with short hospital stay after laparoscopic donor nephrectomy. Urology. 2007;69: 828–31.
Breda A, Veale J, Liao J, et al. Complications of laparoscopic living donor nephrectomy and their management: the UCLA experience. Urology. 2007;69:49–52.
Chin EH, Hazzan D, Herron DM, et al. Laparoscopic donor nephrectomy: intraoperative safety, immediate morbidity, and delayed complications with 500 cases. Surg Endosc. 2007;21:521–6.
Pareek G, Hedican SP, Gee JR, et al. Meta-analysis of the complications of laparoscopic renal surgery: comparison of procedures and techniques. J Urol. 2006;175:1208–13.
Abreu SC, Goldfarb DA, Derweesh I, et al. Factors related to delayed graft function after laparoscopic live donor nephrectomy. J Urol. 2004;171:52–7.
Lee KS, Hong JH, Jeon SS, et al. Comparison of graft survival in live donor nephrectomy: hand-assisted laparoscopic v open procedures. J Endourol. 2007;21:866–71.
Ruiz-Deya G, Cheng S, Palmer E, et al. Open donor, laparoscopic donor and hand assisted laparoscopic donor nephrectomy: a comparison of outcomes. J Urol. 2001;166:1270–3; discussion 1273–4.
Bargman V, Sundaram CP, Bernie J, et al. Randomized trial of laparoscopic donor nephrectomy with and without hand assistance. J Endourol. 2006;20:717–22.
Velidedeoglu E, Williams N, Brayman KL, et al. Comparison of open, laparoscopic, and hand-assisted approaches to live-donor nephrectomy. Transplantation. 2002;74:169–72.
Kocak B, Baker TB, Koffron AJ, et al. Laparoscopic living donor nephrectomy: a single-center sequential experience comparing hand-assisted versus standard technique. Urology. 2007;70:1060–3.
Bachmann A, Wolff T, Ruszat R, et al. Retroperitoneoscopic donor nephrectomy: a retrospective, non-randomized comparison of early complications, donor and recipient outcome with the standard open approach. Eur Urol. 2005;48:90–6; discussion 96.
Tooher RL, Rao MM, Scott DF, et al. A systematic review of laparoscopic live-donor nephrectomy. Transplantation. 2004;78:404–14.
Hubert J, Renoult E, Mourey E, et al. Complete robotic-assistance during laparoscopic living donor nephrectomies: an evaluation of 38 procedures at a single site. Int J Urol. 2007;14:986–9.
Horgan S, Galvani C, Gorodner MV, et al. Effect of robotic assistance on the “learning curve” for laparoscopic hand-assisted donor nephrectomy. Surg Endosc. 2007;21: 1512–7.
Gill IS, Canes D, Aron M, et al. Single port transumbilical (E-NOTES) donor nephrectomy. J Urol. 2008;180:637–41; discussion 641.
Desai M. Single-port surgery for donor nephrectomy: a new era in laparoscopic surgery? Nat Clin Pract Urol. 2009;6:1.
Morrisroe SN, Wall RT, Lu AD. Unilateral pulmonary edema after laparoscopic donor nephrectomy: report of two cases. J Endourol. 2007;21:760–2.
Biglarnia A, Bergqvist D, Johansson M, et al. Venous thromboembolism in live kidney donors – a prospective study. Transplantation. 2008;86:659–61.
Rehman J, Boglia J, Chughtai B, et al. High body mass index in muscular patients and flank position are risk factors for rhabdomyolysis: case report after laparoscopic live-donor nephrectomy. J Endourol. 2006;20:646–50.
Glassman DT, Merriam WG, Trabulsi EJ, et al. Rhabdomyolysis after laparoscopic nephrectomy. JSLS. 2007;11:432–7.
Kuang W, Ng CS, Matin S, et al. Rhabdomyolysis after laparoscopic donor nephrectomy. Urology. 2002;60:911.
Kok NF, Ijzermans JN, Schouten O, et al. Laparoscopic donor nephrectomy in obese donors: easier to implement in overweight women? Transpl Int. 2007;20:956–61.
Thomas MA, Rha KH, Ong AM, et al. Optical access trocar injuries in urological laparoscopic surgery. J Urol. 2003;170:61–3.
Siqueira TM Jr, Paterson RF, Kuo RL, et al. The use of blunt-tipped 12-mm trocars without fascial closure in laparoscopic live donor nephrectomy. JSLS. 2004;8:47–50.
Regan JP, Cho ES, Flowers JL. Small bowel obstruction after laparoscopic donor nephrectomy. Surg Endosc. 2003;17:108–10.
Biggs G, Hafron J, Feliciano J, et al. Treatment of splenic injury during laparoscopic nephrectomy with BioGlue, a surgical adhesive. Urology. 2005;66:882.
Friedman AL, Peters TG, Jones KW, et al. Fatal and nonfatal hemorrhagic complications of living kidney donation. Ann Surg. 2006;243:126–30.
Rosenblatt GS, Conlin MJ. Clipless management of the renal vein during hand-assist laparoscopic donor nephrectomy. BMC Urol. 2006;6:23.
Sundaram CP, Bargman V, Bernie JE. Methods of vascular control during laparoscopic donor nephrectomy. J Endourol. 2006;20:467–9; discussion 469–70.
Leonardo C, Guaglianone S, De Carli P, et al. Laparoscopic nephrectomy using Ligasure system: preliminary experience. J Endourol. 2005;19:976–8.
Constant DL, Florman SS, Mendez F, et al. Use of the LigaSure vessel sealing device in laparoscopic living-donor nephrectomy. Transplantation. 2004;78:1661–4.
Landman J, Kerbl K, Rehman J, et al. Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model. J Urol. 2003;169:697–700.
Kerbl K, Chandhoke PS, Clayman RV, et al. Ligation of the renal pedicle during laparoscopic nephrectomy: a comparison of staples, clips, and sutures. J Laparoendosc Surg. 1993;3:9–12.
Casale P, Pomara G, Simone M, et al. Hem-o-lok clips to control both the artery and the vein during laparoscopic nephrectomy: personal experience and review of the literature. J Endourol. 2007;21:915–8.
Sooriakumaran P, Kommu SS, Cooke J, et al. Evaluation of a commercial vascular clip: risk factors and predictors of failure from in vitro studies. BJU Int. 2009;103:1410–2.
Baumert H, Ballaro A, Arroyo C, et al. The use of polymer (Hem-o-lok) clips for management of the renal hilum during laparoscopic nephrectomy. Eur Urol. 2006;49:816–9.
Ponsky L, Cherullo E, Moinzadeh A, et al. The Hem-o-lok clip is safe for laparoscopic nephrectomy: a multi-institutional review. Urology. 2008;71:593–6.
Deng DY, Meng MV, Nguyen HT, et al. Laparoscopic linear cutting stapler failure. Urology. 2002;60:415–9; discussion 419–20.
Meng MV, Freise CE, Kang SM, et al. Techniques to optimize vascular control during laparoscopic donor nephrectomy. Urology. 2003;61:93–7; discussion 97–8.
Kouba E, Smith AM, Derksen JE, et al. Efficacy and safety of en bloc ligation of renal hilum during laparoscopic nephrectomy. Urology. 2007;69:226–9.
Sharma A, Heer M, Subramanaym Malladi SV, et al. Chylous ascites after laparoscopic donor nephrectomy. J Endourol. 2005;19:839–40.
Shafizadeh SF, Daily PP, Baliga P, et al. Chylous ascites secondary to laparoscopic donor nephrectomy. Urology. 2002;60:345.
Caumartin Y, Pouliot F, Sabbagh R, et al. Chylous ascites as a complication of laparoscopic donor nephrectomy. Transpl Int. 2005;18:1378–81.
Kim FJ, Pinto P, Su LM, et al. Ipsilateral orchialgia after laparoscopic donor nephrectomy. J Endourol. 2003;17:405–9.
Gjertson CK, Sundaram CP. Testicular pain following laparoscopic renal surgery. J Urol. 2008;180:2037–40; discussion 2040–1.
Metcalfe PD, Hickey L, Lawen JG. Bladder perforation during laparoscopic donor nephrectomy. Can J Urol. 2004;11:2456–8.
Helling TS. Injuries incurred during laparoscopic donor nephrectomy with the endocatch recovery system. Am J Transplant. 2006;6:1088.
Soulsby RE, Evans LJ, Rigg KM, et al. Warm ischemic time during laparoscopic live donor nephrectomy: effects on graft function. Transplant Proc. 2005;37:620–2.
Mohamed HK, Lin A, Savage SJ, et al. Parenchymal transection of the kidney inflicted by endocatch bag entrapment during a laparoscopic donor nephrectomy. Am J Transplant. 2006;6:232–5.
Shalhav AL, Siqueira TM Jr, Gardner TA, et al. Manual specimen retrieval without a pneumoperitoneum preserving device for laparoscopic live donor nephrectomy. J Urol. 2002;168:941–4.
Sasaki TM, Finelli F, Bugarin E, et al. Is laparoscopic donor nephrectomy the new criterion standard? Arch Surg. 2000;135:943–7.
Bergman S, Feldman LS, Carli F, et al. Intraoperative fluid management in laparoscopic live-donor nephrectomy: challenging the dogma. Surg Endosc. 2004;18:1625–30.
Brennan TV, Freise CE, Fuller TF, et al. Early graft function after living donor kidney transplantation predicts rejection but not outcomes. Am J Transplant. 2004;4:971–9.
Novick AC: Renal hypothermia: in vivo and ex vivo. Urol Clin North Am. 1983;10:637–44.
Jablonski P, Howden B, Leslie E, et al. Recovery of renal function after warm ischemia. I. The effect of chlorpromazine and phenoxybenzamine. Transplantation. 1983;35:535–9.
Mertens zur Borg IR, Lim A, Verbrugge SJ, et al. Effect of intraabdominal pressure elevation and positioning on hemodynamic responses during carbon dioxide pneumoperitoneum for laparoscopic donor nephrectomy: a prospective controlled clinical study. Surg Endosc. 2004;18:919–23.
McDougall EM, Monk TG, Wolf JS Jr, et al. The effect of prolonged pneumoperitoneum on renal function in an animal model. J Am Coll Surg. 1996;182:317–28.
Lind MY, Hazebroek EJ, Bajema IM, et al. Effect of prolonged warm ischemia and pneumoperitoneum on renal function in a rat syngeneic kidney transplantation model. Surg Endosc. 2006;20:1113–8.
Iwata T, Gilispie A, Jorns C, et al. Microdialysis monitoring for evaluation of the influence exerted by pneumoperitoneum on the kidney: an experimental study. Surg Endosc. 2008;22:938–42.
Bolte SL, Chin LT, Moon TD, et al. Maintaining urine production and early allograft function during laparoscopic donor nephrectomy. Urology. 2006;68:747–50.
Mertens zur Borg IR, Kok NF, Lambrou G, et al. Beneficial effects of a new fluid regime on kidney function of donor and recipient during laparoscopic v open donor nephrectomy. J Endourol. 2007;21:1509–15.
Mertens zur Borg IR, Di Biase M, Verbrugge S, et al. Comparison of three perioperative fluid regimes for laparoscopic donor nephrectomy: a prospective randomized dose-finding study. Surg Endosc. 2008;22:146–50.
Amukele SA, Belletete B, Samadi AA, et al. Urologic complications in renal transplant recipients by donor type. J Endourol. 2006;20:771–5.
Breda A, Bui MH, Liao JC, et al. Incidence of ureteral strictures after laparoscopic donor nephrectomy. J Urol. 2006;176:1065–8.
Lind MY, Hazebroek EJ, Kirkels WJ, et al. Laparoscopic versus open donor nephrectomy: ureteral complications in recipients. Urology. 2004;63:36–9; discussion 39–40.
Rizvi SA, Naqvi SA, Jawad F, et al. Living kidney donor follow-up in a dedicated clinic. Transplantation. 2005;79:1247–51.
Sansalone CV, Maione G, Aseni P, et al. Early and late residual renal function and surgical complications in living donors: a 15-year experience at a single institution. Transplant Proc. 2006;38:994–5.
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Wedmid, A., Palese, M.A. (2010). Complications of Laparoscopic Donor Nephrectomy. In: Ghavamian, R. (eds) Complications of Laparoscopic and Robotic Urologic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-60761-676-4_11
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