Laparoscopic live donor nephrectomy: A comparison with the conventional open approach

Purpose: Laparoscopic live donor nephrectomy is an emerging technique that has not yet gained widespread acceptance in the transplant community due to perceived technical difficulties. However, the potential advantages of dec reasing donor morbidity, decreasing hospital stay and improving convalescen ce while producing a functional kidney for the recipient may prove to enhan ce living related renal transplantation. We report our early experience wit h laparoscopic live donor nephrectomy. Materials and Methods: We retrospectively reviewed the medical records of 5 0 consecutive laparoscopic nephrectomies performed from October 1998 to May 2000 and compared them with 50 consecutive open donor nephrectomies, which served as historical controls. Results: Donor age, donor sex and number of HLA mismatches did not differ s tatistically in the 2 groups. In the laparoscopic and open nephrectomy grou ps mean followup was 109 and 331 days (p = 0.0001), mean operative time was 234 and 208 minutes (p = 0.0068), mean estimated blood loss was 114 and 19 3 ml. (p = 0.0001), and mean hospital stay was 3.5 and 4.7 days (p = 0.0001 ), respectively. Average renal warm ischemia time was 2.8 minutes in the la paroscopic nephrectomy group. Serum creatinine did not differ statistically in the 2 groups preoperatively or postoperatively at days 1 and 5, and 1 m onth. The rate of recipient ureteral complications in the laparoscopic and open nephrectomy groups was 2% (1 of 50 cases) and 6% (3 of 50), respective ly (not significant). Conclusions: Laparoscopic live donor nephrectomy is an attractive alternati ve to open donor nephrectomy. Laparoscopic nephrectomy results in less post operative discomfort, an improved cosmetic result and more rapid recovery f or the donor with equivalent functional results and complications.