Skip to main content
SpringerLink
Log in

The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy.

Materials and methods

We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers.

Results

Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (n = 35) and bleeding (n = 17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58–35.7), p < 0.001] or conversion to open surgery [OR 18.96 (3.42–105.14), p = 0.0042]. Postoperative complications were noted in 99 patients (32%), including 12 patients (3.9%) with Clavien–Dindo grade III–IV complications. On multivariate analysis, a high MAP score was also associated with the risk of postoperative complications [OR 2.55 (1.20–5.40), p = 0.01].

Conclusions

In this retrospective bicentric study, a high MAP score was associated with the risk of intra- and postoperative complications of laparoscopic donor nephrectomy. The MAP score appears of interest in the living donor evaluation process to help improve donors’ information and outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

De-identified data can be made readily available to reviewers upon request.

Code availability

Statistical software can be made readily available to reviewers upon request.

References

  1. Axelrod DA, Schnitzler MA, Xiao H et al (2018) An economic assessment of contemporary kidney transplant practice. Am J Transpl 18:1168–1176. https://doi.org/10.1111/ajt.14702

    Article  Google Scholar 

  2. Heldal K, Midtvedt K, Lønning K et al (2019) Kidney transplantation: an attractive and cost-effective alternative for older patients? A cost-utility study. Clin Kidney J 12:888–894. https://doi.org/10.1093/ckj/sfz018

    Article  PubMed  PubMed Central  Google Scholar 

  3. Yohanna S, Naylor KL, McArthur E et al (2020) A propensity score-weighted comparison of outcomes between living and standard criteria deceased donor kidney transplant recipients. Transplantation. https://doi.org/10.1097/TP.0000000000003337

    Article  PubMed  Google Scholar 

  4. Ahmadpoor P, Seifi B, Zoghy Z et al (2020) Time-varying covariates and risk factors for graft loss in kidney transplantation. Transpl Proc. https://doi.org/10.1016/j.transproceed.2020.06.015

    Article  Google Scholar 

  5. Englum BR, Schechter MA, Irish WD et al (2015) Outcomes in kidney transplant recipients from older living donors. Transplantation 99:309–315. https://doi.org/10.1097/TP.0000000000000607

    Article  PubMed  Google Scholar 

  6. Andersen MH, Mathisen L, Oyen O et al (2006) Postoperative pain and convalescence in living kidney donors-laparoscopic versus open donor nephrectomy: a randomized study. Am J Transpl 6:1438–1443. https://doi.org/10.1111/j.1600-6143.2006.01301.x

    Article  CAS  Google Scholar 

  7. Grams ME, Sang Y, Levey AS et al (2016) Kidney-failure risk projection for the living kidney-donor candidate. N Engl J Med 374:411–421. https://doi.org/10.1056/NEJMoa1510491

    Article  CAS  PubMed  Google Scholar 

  8. Janki S, Dehghan A, van de Wetering J et al (2020) Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts. Eur J Epidemiol 35:699–707. https://doi.org/10.1007/s10654-020-00647-y

    Article  PubMed  PubMed Central  Google Scholar 

  9. Davidiuk AJ, Parker AS, Thomas CS et al (2014) Mayo Adhesive Probability score: an accurate image-based scoring system to predict adherent perinephric fat in partial nephrectomy. Eur Urol 66:1165–1171. https://doi.org/10.1016/j.eururo.2014.08.054

    Article  PubMed  Google Scholar 

  10. Khene Z-E, Peyronnet B, Kocher NJ et al (2018) Predicting morbidity after robotic partial nephrectomy: the effect of tumor, environment, and patient-related factors. Urol Oncol 36:338.e19-338.e26. https://doi.org/10.1016/j.urolonc.2018.04.005

    Article  Google Scholar 

  11. Bier S, Aufderklamm S, Todenhöfer T et al (2017) Prediction of postoperative risks in laparoscopic partial nephrectomy using RENAL Mayo adhesive probability and renal pelvic score. Anticancer Res 37:1369–1373. https://doi.org/10.21873/anticanres.11457

    Article  PubMed  Google Scholar 

  12. Cockerill KJ, Young S, Ball, CT et al (2019) The association of the Mayo adhesive probability (MAP) score with total operative time in patients undergoing hand-assisted laparoscopic donor nephrectomy. Urology 124:142–147. https://doi.org/10.1016/j.urology.2018.10.041

    Article  PubMed  Google Scholar 

  13. Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196. https://doi.org/10.1097/SLA.0b013e3181b13ca2

    Article  PubMed  Google Scholar 

  14. Kuo PC, Johnson LB (2000) Laparoscopic donor nephrectomy increases the supply of living donor kidneys: a center-specific microeconomic analysis. Transplantation 69:2211–2213. https://doi.org/10.1097/00007890-200005270-00047

    Article  CAS  PubMed  Google Scholar 

  15. Kutikov A, Uzzo RG (2009) The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol 182:844–853. https://doi.org/10.1016/j.juro.2009.05.035

    Article  PubMed  Google Scholar 

  16. Ficarra V, Novara G, Secco S et al (2009) Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol 56:786–793. https://doi.org/10.1016/j.eururo.2009.07.040

    Article  PubMed  Google Scholar 

  17. Sterkenburg A, Kulu Y, Mieth M et al (2020) Long-term surgical outcome and risk factors in living kidney donors. Transpl Proc. https://doi.org/10.1016/j.transproceed.2019.12.044

    Article  Google Scholar 

  18. Wilson CH, Sanni A, Rix DA, Soomro NA (2011) Laparoscopic versus open nephrectomy for live kidney donors. Cochrane Database Syst Rev CD 006124. https://doi.org/10.1002/14651858.CD006124.pub2

    Article  Google Scholar 

  19. Mjøen G, Øyen O, Holdaas H et al (2009) Morbidity and mortality in 1022 consecutive living donor nephrectomies: benefits of a living donor registry. Transplantation 88:1273–1279. https://doi.org/10.1097/TP.0b013e3181bb44fd

    Article  PubMed  Google Scholar 

  20. Burkhalter F, Huynh-Do U, Hadaya K et al (2017) Early complications after living donor nephrectomy: analysis of the Swiss Organ Living Donor Health Registry. Swiss Med Wkly 147:w14497. https://doi.org/10.4414/smw.2017.14497

    Article  PubMed  Google Scholar 

  21. Fisher PC, Montgomery JS, Johnston WK, Wolf JS (2006) 200 consecutive hand assisted laparoscopic donor nephrectomies: evolution of operative technique and outcomes. J Urol 175:1439–1443. https://doi.org/10.1016/S0022-5347(05)00648-8

    Article  PubMed  Google Scholar 

  22. Rowley MW, Wolf JS (2011) Risk factors for conversion to hand assisted laparoscopy or open surgery during laparoscopic renal surgery. J Urol 185:940–944. https://doi.org/10.1016/j.juro.2010.10.063

    Article  PubMed  Google Scholar 

Download references

Funding

Gaelle Fiard receives funding from the Fondation de France and the European Urology Scholarship Program.

Author information

Authors and Affiliations

  1. Department of Urology and Kidney Transplantation, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex 9, France

    Quentin Franquet, Nicolas Terrier, Jean-Jacques Rambeaud, Jean-Alexandre Long, Delphine Poncet, Jean-Luc Descotes & Gaelle Fiard

  2. Department of Urology and Transplantation, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France

    Xavier Matillon, Sebastien Crouzet, Hakim Fassi-Fehri, Ricardo Codas-Duarte & Lionel Badet

  3. Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, 38000, Grenoble, France

    Jean-Alexandre Long, Jean-Luc Descotes & Gaelle Fiard

  4. Department of Nephrology, Hemodialysis, Apheresis and Kidney Transplantation, Grenoble Alpes University Hospital, Grenoble, France

    Thomas Jouve, Johan Noble, Paolo Malvezzi & Lionel Rostaing

Authors
  1. Quentin Franquet
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xavier Matillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicolas Terrier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Jacques Rambeaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sebastien Crouzet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean-Alexandre Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hakim Fassi-Fehri
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ricardo Codas-Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Delphine Poncet
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Thomas Jouve
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Johan Noble
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Paolo Malvezzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Lionel Rostaing
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Jean-Luc Descotes
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Lionel Badet
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Gaelle Fiard
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

QF: protocol/project development, data collection or management, data analysis, manuscript writing/editing. XM: data collection or management, manuscript writing/editing. NT: protocol/project development, manuscript writing/editing. JJR: protocol/project development. SC: manuscript writing/editing. JAL: data analysis, manuscript writing/editing. HF-F: data collection or management. RC-D: data collection or management. DP: data collection or management. TJ: manuscript writing/editing. JN: manuscript writing/editing. PM: manuscript writing/editing. LR: manuscript writing/editing. JLD: protocol/project development. LB: protocol/project development. GF: protocol/project development, manuscript writing/editing.

Corresponding author

Correspondence to Gaelle Fiard.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

This retrospective study conducted from medical charts used data obtained during routine care. Study was registered under data management reference methodology number MR 2910211218.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file 1 (DOCX 14 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Franquet, Q., Matillon, X., Terrier, N. et al. The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy. World J Urol 39, 2775–2781 (2021). https://doi.org/10.1007/s00345-020-03513-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-020-03513-4

Keywords

Search

Navigation