Most Complications of Hand-Assisted Laparoscopic Living Donor Nephrectomy Occur after Initial Discharge Including Most Reoperations: A Single-Center Retrospective Study

X. Benavides, R. T. Rogers, E. Tan, M. A. Merzkani, S. Thirunavukkarasu, B. Smith, A. D. Rule, M. Prieto, J. K. Heimbach, T. Taner, G. K. Chow, P. G. Dean, M. D. Stegall

Kidney Transplant, Mayo Clinic, Rochester, MN

Meeting: 2020 American Transplant Congress

Abstract number: B-028

Keywords: Adverse effects, Donation, Morbidity

Session Information

Session Name: Poster Session B: Kidney Living Donor: Other

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: While most studies of hand-assisted laparoscopic living donor nephrectomy (HALLDN) report complications until discharge, this study examined complications up to 120 days.

*Methods: We assessed complications (Clavien-Dindo Classification) of all HALLDNs (1/2000 to 7/2018) from surgery to discharge and per our center’s protocolized follow-up to 120 days.

*Results: Of 2837 HALLDNs, 2764 had research consent, including 87.3% Caucasians, 58.3% females, mean age 44.3 yrs. (18-77); 14.9% active smokers; BMI 30-35= 22.94%, BMI >35=7.3% and 35.9% prior abdominal surgery. Compared to US registry data¹ (Table), this population had more Caucasians, smokers, right kidneys, and donors with BMI>30. Complications to discharge (n=55, 2.0%) were lower compared to registry data and included 12 open conversions (0.43%). Post-discharge follow-up was incomplete: 438 (15.8%) no follow up, 751 (27.1%) 1-119 days, and 1575 (57.0%) the full 120 days. Of the total known complications, 81% occurred after discharge, including one IV (acute kidney injury/transient dialysis due to retroperitoneal fibrosis), 39 III (reoperations mostly for hernias/dehiscence); and 89 II (including 59 wound infections and 16 urinary tract infections). There were no donor deaths in the 120 day follow-up period.

*Conclusions: The retrospective study supports prior findings that large volume centers have less perioperative complications. However, our data also suggest that the current literature underreports complications of HALLDN in that 81% of all complications occurred after discharge, including 86.7% of reoperations.

To cite this abstract in AMA style:

Benavides X, Rogers RT, Tan E, Merzkani MA, Thirunavukkarasu S, Smith B, Rule AD, Prieto M, Heimbach JK, Taner T, Chow GK, Dean PG, Stegall MD. Most Complications of Hand-Assisted Laparoscopic Living Donor Nephrectomy Occur after Initial Discharge Including Most Reoperations: A Single-Center Retrospective Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/most-complications-of-hand-assisted-laparoscopic-living-donor-nephrectomy-occur-after-initial-discharge-including-most-reoperations-a-single-center-retrospective-study/. Accessed November 22, 2024.

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