EXPERIENCE WITH LIVING-RELATED DONOR NEPHRECTOMY - EVALUATION OF 200 CASES

Over a ten year period (1979 to 1989), 200 patients have undergone liv e donor nephrectomy through a flank extraperitoneal approach without r ib resection. The average hospital stay was short and the major compli cations were negligible. Early graft function was seen in 97% of the c ases. Delayed function due to acute tubular necrosis developed in 3%. Urinary leak was seen in 3%. Two kidneys were lost due to infection re lated to urinary fistulae. In 70 donors, 37 +/- 23 months' follow-up w as available. Hypertension developed in two patients three and three a nd one-half years post donation. Significant proteinuria (>300 mg/day) was noted in one patient. No significant renal functional abnormaliti es were observed. Creatinine clearance was about 70% of the initial me asurement at the observation time. We conclude that extraperitoneal fl ank live donor nephrectomy is generally safe and associated with minim al perioperative and long-term morbidity. Moreover, the procedure prov ides an excellent allograft function.