Improved recipient results after 5 years of performing laparoscopic donor nephrectomy
Section snippets
Methods
A retrospective review of all living donor operations performed at the Johns Hopkins Medical Institutions between January 1995 and July 1999 was conducted. All pediatric and adult recipients from related and unrelated donors were included in the study. During the study period, a total of 248 living donor transplants were performed. Two hundred of these operations were carried out using the LapNx techniques, and 48 individuals had the standard OpenNx via a flank incision.
Statistical analysis of
Ischemic time and renal anatomy
The warm ischemic times for kidneys procured by the LapNx procedures were within an acceptable range (Table 1). There was no significant difference in the serum creatinine on postoperative day 4 between the LapNx and OpenNx groups (data not shown). The mean lengths of the renal vein, artery, and ureter were 4.6 ± 1.2, 3.4 ± 0.9, and 11.6 ± 2.4, respectively. Vascular and ureteral lengths of the donor kidneys were adequate in all cases to perform the recipient operation using standard
Discussion
Numerous strategies have been employed to increase cadaveric organ donation with only modest success. There continues to be a widening disparity between kidneys available for transplantation and patients on the waiting list. Longer waiting times have translated into an increase in mortality among individuals awaiting renal transplantation. Kidneys procured from living donors offer a number of advantages when compared to cadaveric donor sources. Among these advantages are the ability to perform
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Cited by (64)
Surgical Approaches and Outcomes in Living Donor Nephrectomy: A Systematic Review and Meta-analysis
2022, European Urology FocusCitation Excerpt :This may also be because LDN is chosen for more easily accessible kidneys, as 95.5% of all LDN procedures in this review were left-sided. Montgomery et al [53] reported a higher graft loss rate for their first 100 LDN procedures compared to the second 100. The graft losses were seen mainly in right kidney donor nephrectomies among the first 100 procedures.
Kidney Transplantation: Have the Promises Been Kept and Needs Met
2017, Kidney Transplantation, Bioengineering, and Regeneration: Kidney Transplantation in the Regenerative Medicine EraLaparoscopic donor nephrectomy: The Middle East experience
2012, Arab Journal of UrologyCitation Excerpt :The initial American and worldwide experience was also clouded by critics against laparoscopy, claiming a higher complication rate for the donor and recipient, based on the initial studies from Johns Hopkins University and the University of Maryland [8–11]. The same centres, as well as others, have responded to this criticism by modifying the technique, yielding improved success rates and overall results [12–15]. In this review we describe the Middle East experience with LDN that was initiated in 2000, 5 years after the initial report from Baltimore [16].
Laparoscopic donor nephrectomy: Single-center experience
2012, Transplantation ProceedingsRetrospective evaluation of donor pain and pain management after laprascopic nephrectomy
2011, Transplantation ProceedingsMinimally invasive surgical training: Challenges and solutions
2009, Urologic Oncology: Seminars and Original InvestigationsCitation Excerpt :With the advent of the laparoscopic radical nephrectomy in the early 1990s [1], urology has seen an explosion in minimally invasive approaches applied to malignant disease. Postoperative pain, convalescence, and hospital stays among other measures have been shown to be favorable for laparoscopic radical nephrectomy [2–4], and since then for nephroureterectomy [5,6], partial nephrectomy [7,8], prostatectomy [9,10], and retroperitoneal lymph node dissection [11]. Favorable long-term oncologic outcomes have now been reported for laparoscopic radical nephrectomy [2,3], nephroureterectomy [5,6], and partial nephrectomy [7,8] and, in turn, the use of minimally invasive techniques is expanding.