Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*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 24, 2020.
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