Laparoscopic versus conventional live donor nephrectomy: Experience in a community transplant program

Fifty-nine consecutive patients underwent live donor nephrectomy for transp lantation. Twenty-nine patients (Group I) had open kidney procurement, and 30 patients (Group II) had laparoscopic procurement. The mean operative tim e in Group I was 2:30 hours (range 1:55-2:59), whereas in Group II it was 3 :01 hours (1:54-5:21). All kidneys functioned immediately after transplanta tion. The average warm ischemia time was not calculated in Group I; it was 3.9 minutes (2-15) in Group II. Intraoperative complications occurred in tw o patients in Group II. One patient had bleeding from an accessory renal ar tery. The second patient had a tear in the splenic capsule. No ureteral com plications occurred in either group. Postoperatively one patient in Group I developed incisional hernia, one developed pneumothorax, and two developed atelectasis. In Group II one patient developed pancreatitis, one developed flank ecchymosis, and two had suprapubic wound hematomas. Using the laparo scopic approach the hospital stay decreased from 4.1 to 1.27 days (69%) (P < 0.001) and return to work decreased from 28.4 to 14.8 days (49%) (P < 0.0 1). Live donation increased by 67 per cent. We conclude that the laparoscop ic procurement of kidneys for transplantation compares well with the open m ethod. It offers several advantages that may increase the living donor pool .