Laparoscopic living donor nephrectomy. First own experiences and review ofthe literature

Despite improved success rates,the number of kidney transplantations in Ger many in the last few years has stagnated, resulting in increasing waiting l ists of patients on dialysis. In Germany only 16.7% of kidney transplantati ons are living-donor nephrectomies, representing a relatively low rate comp ared to other countries (The Netherlands 28%, Sweden 35%). Since April 1998, we have performed ten retroperitoneoscopic living-donor n ephrectomies (six left, four right side). The mean operating time was 216 m in (155-290) with minimal blood loss. No intraoperative complications were observed. Warm ischemia time amounted to a mean of 4 min (2-7). The mean co ld ischemia time was 165 min (76-290). Postoperative hospital stay of the d onors was 6 days (4-10). All transplants functioned immediately; mean serum creatinine dropped from initially 8.0 mg/dl (5.3-11.5) on day 1 to 1.4 mg/ dl (0.9-1.6) 3 months after surgery. This did not differ from previously op erated open donor nephrectomies. An analysis of the literature included data of 4240 patients from 25 public ations between 1980 and 2000 reporting on either open or laparoscopic livin g donor nephrectomies.