It is important to have a better understanding of the short and long term outcomes and risks of kidney donation. We studied the occurrence of acute operative complications and 1,5,& 10 year outcomes in living donors by type of nephrectomy. From Jan 1, 2001 until Dec 31, 2013 inclusive, all live kidney donors in the U.K were included in the study. Dec 31, 2014 was considered the study end, so that all patients had at least one year of follow-up. A total of 9750 live donor records were available. Nephrectomy type was available for 9602 donors; Open 3132 (33%), Pure laproscopic (PL)- 3886 (38%) and hand assisted laproscopic (HAL)– 2802 (29%). We analysed the incidence of operative complications; splenectomy, reoperation required, organ perforation, operative haemorrhage, pneumonia, pneumothorax, pulmonary embolism, wound infection, DVT, other complications and a combined variable for any one or more complication. Statistically significant differences were noted for the incidence of reoperation (41/2794, P=0.018), organ perforation (44/2802, P=0.032), wound Infection (60/ 2796, P=0.018), other complication (323/2793, P<0.0001), any one or more complications (402/2802 P<0.0001) in the HAL group when compared to the other 2 groups. Incidence of operative haemorrhage (64/3122, P<0.0001) and pneumothorax (46/3130, P<0.0001) were higher in open nephrectomies. PL nephrectomy yielded the least complications. Long term outcomes were analysed. At one year, there was significantly more wound pain in the open group P=0.001. Incisional and operation related hernia was more in the HAL group P=0.048. Other operation related conditions was more in the laparoscopic groups, P=0.024. At five years (n= 6011) wound pain remained significant with more wound pain in open nephrectomy group: 9/2814 vs. 0/ 2282 P=0.007. At 10 years (n=1863) there were only 2 donors with wound pain, both in the open group. Also all laparoscopic procedures were pure, as the HAL only started in 2007 in the U.K. Though there were small numbers of complications overall, significant differences were identified with most complications seen in HAL nephrectomies and least in PL operations. Wound pain remained significant in longterm outcomes and was mainly related to open nephrectomy.

CITATION INFORMATION: Krishnan N, Bradbury L, Raymond N. Acute Operative Complications and 1,5,& 10 Year Outcomes in Living Donors by Type of Live Donor Nephrectomy – UK Cohort Study. Am J Transplant. 2016;16 (suppl 3).

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