*Purpose: The left kidney is usually selected for laparoscopic donor nephrectomy while the right kidney raises concerns for donors’ and recipients’ safety and presents a difficulty for venous anastomosis and results in worse allograft kidney function due to the shortness of the renal vein. Here, we investigated the safety and the peri- and post-operative outcomes for right donor nephrectomy compared to left.

*Methods: We retrospectively analyzed the clinical records of living donor-kidney transplant donors/recipients and evaluated peri-operative and post-operative outcomes such as operative time, ischemic time, blood loss, and surgical complications in the donor, as well as kidney allograft function in the recipients according to the laterality of donated kidneys.

*Results: We identified 169 donor/recipient combinations (left : right =133 : 36 cases). Donor’s age (left and right, median, 58.0 and 57.5 yrs), BMI (22.65 and 22.52), and sex (male, 33.8% and 55.5%) were comparable between the groups. The reasons to select right kidney for donation were lower split renal function than 45% or scarred kidney (12 cases), renal stone (8 cases), segmental arterial disease (4 cases), benign tumor (1 cases) in the right side, and avoiding left kidney complicated with multiple arteries (10 cases), respectively. In the comparison of perioperative period, warm ischemic time (left vs right, median, 270 vs 247 seconds), total ischemic time (105 vs 123 min), blood loss (115 vs 112 mL), and operative time (249 vs 253 min) were similar between the groups. In terms of surgical complication (higher than Clavien Dindo grade II), there were open conversions in 2 donors (1 case in each side), delayed graft function requiring temporary hemodialysis in 3 recipients (2 in the left and 1 in the right side, respectively), and ileus in 1 case in the left side. eGFR were comparable at 6 months post-transplant.

*Conclusions: Peri- and post-operative outcomes were both excellent and similar in both donated sides in retroperitoneoscopic donor nephrectomy. Therefore, there is no reason to avoid right side for donation in this operative procedure.

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