Hand-Assisted Laparoscopic Donor Nephrectomy: Experience with Over 2400 Cases at a Single Center.
1Division of Transplant Surgery, Mayo Clinic, Rochester, MN
2Division of Transplant Surgery, Medical University of South Carolina, Charleston, SC.
Meeting: 2016 American Transplant Congress
Abstract number: C163
Session Information
Session Name: Poster Session C: Kidney Donor Evaluation and Donor Nephrectomy
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Objective: We reviewed retrospectively the 15 year experience with Hand-Assisted Laparoscopic Donor Nephrectomy (HALDN) at our institution.
Methods: 2452 consecutive kidney donors underwent a HALDN between January 2000 and July 2015. Our internal transplant database and Electronic Medical Record were reviewed to identify patient demographics, operative complications, duration of surgery, length of stay, and hospital readmissions. Renal function (GFR) was measured by iothalamate clearance and estimated by the abbreviated MDRD equation.
| [table1] | |
| Age | 43.13±11.8 (18-77) |
| Gender | 53.57% |
| BMI | 27.86±9 (18-41) |
| Hospital days | 2.2±0.9 |
| Incision to Crossclamp | 84±28 min |
| Lengh of operation | 129±29 min |
| Right Kidney | 21% |
| Iothalamate GFR | 104±18ml/min/SA |
| 4 month Iothalamate GFR | 66±13ml/min/SA |
,
| [table2] | Cases | |
| Intraoperative complications | Conversion to open | 8 |
| Bowel Injury | 2 | |
| Injury to Graft | 1 | |
| Pneumothorax | 1 | |
| Incidental Cystotomy | 1 | |
| Post-operative Complications | Ventral Hernia | 16 |
| Wound Infectiion | 12 | |
| Small Bowel obstruction | 10 | |
| Ileus/Constipation | 8 | |
| Urinary Retention | 8 | |
| Readmissions (30days post) | GI symptoms/Pain | 30 |
Results: 2452 out of 3025 solitary kidney transplants during this time period were living donor transplants (81%). All living donors underwent a HALDN. The duration of surgery was 121±29 min, skin incision to cross-clamp was 85±27 min; 13 patients had concomitant surgery during donation. The average hospital stay was 2.2±0.9 days. Right nephrectomies were performed in 21% of the patients; 179 (7%) of donors had BMI >35 at the time of donation; There was no mortality or long term sequelae. 96.9% of the donors had no complications. 8 (0.3%) cases had to be converted to an open procedure; 10 patients (0.4%) had a small bowel obstruction and 16 patients (0.6%) a ventral hernia after donation requiring reoperation. 30 patients were readmitted due to either pain or GI symptoms. The donor GFR was 104±18 ml/min/SA at the time of donation. 1384 (56%) of donors had a 4 month follow up evaluation after donation. The average GFR at this time was 66±13ml/min/SA.
Conclusion: At 15 years, hand-assisted laparoscopic donor nephrectomy is a safe procedure with low surgical complication rates and satisfactory post donation renal function.
CITATION INFORMATION: Li H, Stegall M, Chow G, Dean P, Heimbach J, Taner T, Prieto M. Hand-Assisted Laparoscopic Donor Nephrectomy: Experience with Over 2400 Cases at a Single Center. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Li H, Stegall M, Chow G, Dean P, Heimbach J, Taner T, Prieto M. Hand-Assisted Laparoscopic Donor Nephrectomy: Experience with Over 2400 Cases at a Single Center. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/hand-assisted-laparoscopic-donor-nephrectomy-experience-with-over-2400-cases-at-a-single-center/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress