Initial experience with hand-assisted laparoscopic donor nephrectomy: a single-centre experience over 5 years

OBJECTIVE: The objective of this study was to evaluate outcome after hand-assisted live donor nephrectomy with a retroperitoneal approach during a 5 year period.

MATERIALS AND METHODS: All donor nephrectomies at Odense University Hospital, Denmark, from January 2008 to December 2012 were identified retrospectively, and the medical records were examined.

RESULTS: In total, 108 patients were enrolled: 68 females, with a median age of 50 years (range 24-68 years), and 40 males, with a median age of 51 years (32-70 years). The median body mass index (BMI) was 25 kg/m² (19-33 kg/m²) in females and 27 kg/m² (21-38 kg/m²) in males. The median intraoperative bleeding was 175 ml. The median warm ischaemia time was 3.2 min (1.5-6.7 min). The median operative time was 230 min (161-360 min). The median hospital stay was 4 days (2-10 days). Thirty donors (28%) had 34 early complications. Six donors (6%) needed reoperation. Late complications were seen in seven (7%). Sixteen donors (15%) were obese (BMI ≥30 kg/m²), which was associated with significant complications (p < .0001). There was a significantly higher complication rate in donors who were smokers and ingested alcohol above the Danish recommended limits (p < .0001). Fifteen donors (13%) developed hypertension postoperatively within the first year. There was no mortality. A total of 104 (96%) of the recipients had a functional transplant after 1 year.

CONCLUSION: Hand-assisted donor nephrectomy is a safe procedure. Potential candidates should be advised to stop smoking and to avoid alcohol before surgery, especially those with a BMI of 30 kg/m² or higher.