Right donor nephrectomy,especially when conducted laparoscopically,has not been accepted by most transplant surgeons because of the consequent short right renal vein and the possible increased incidence of venous thrombosis and other surgical complications. We have evaluated our outcomes of Hand Assisted Laparoscopic Donor nephrectomy (HALD) and we compared between right and left donor nephrectomy.HALD has been performed at our institution since December,1999.Through May 2014, a total of 1,500 HALD procedures have been performed.We decided to perform right donor nephrectomy when there is complex left renal vascular anatomy, the right kidney has a benign pathology, the right kidney is smaller than the left > 20% or the function of the right kidney is less than the left by > 20%.Right Donor Nephrectomy (RDN) was performed in 272 patients and Left Donor Nephrectomy (LDN) was performed in 1,228 patients. Mean donor age was 40.5(18.8-66.9) for RDN group and 40.9(18.5-68.5) for LDN group, BMI was 27.3(18-43) for RDN and 26(16.5-49.8) for LDN. M: F ratio was 108:164 for RDN and 551:677 for LDN. All procedures were successfully completed. Patient and graft survival between the two groups is shown in figures. Death censored early graft loss (within 30 days of transplant) occurred in 4/272 (1.5%) in RDN and 9/1228 (0.7%) in LDN, causes of early graft loss are shown in Table 1.

Delayed Graft Function (DGF) incidence was 5/272 (1.85%) for RDN and 16/1228 (1.3%) for LDN, all patients recovered normal kidney function. Four donors (0.27%) were converted to an open technique due to bleeding, 2 in each group. All conversions occurred during the earlier years of our experience, two in the first year (2000), one in 2002 and the last one in 2003. In conclusion, hand-assisted laparoscopic right donor nephrectomy provides comparable outcomes to left donor nephrectomy and expands living donor utilization for kidney transplant.

CITATION INFORMATION: El-Hinnawi A, Rajab A, Pelletier R. Outcomes of Hand Assisted Laparoscopic Right Donor Nephrectomy, Single Center Experience. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress