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Preoperative Antibiotics Administration is Important to Prevent Hand Port-Site Infection After Hand-Assisted Laparoscopic Donor Nephrectomy for Living-Donor Kidney Transplantation

T. Hiramitsu, T. Tomosugi, K. Futamura, M. Okada, N. Goto, T. Ichimori, S. Narumi, Y. Watarai

Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan

Meeting: 2022 American Transplant Congress

Abstract number: 1033

Keywords: Infection, Kidney transplantation, N/A, Nephrectomy

Topic: Clinical Science » Kidney » 40 - Kidney Living Donor: Other

Session Information

Session Name: Kidney Living Donor: Other

Session Type: Poster Abstract

Date: Sunday, June 5, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Due to the profound organ shortage, the number of living donor kidney transplantation (LDKT) is increasing. Hand-assisted laparoscopic donor nephrectomy (HALDN) is widely performed for living donors. One of the major complications after HALDN is hand port-site infections. This study aimed to reveal the impact of preoperative comorbidities, prophylactic subcutaneous suction drain placement, and preoperative antibiotic prophylaxis on hand port-site infection after HALDN.

*Methods: In this single-center, retrospective cohort study, 950 consecutive HALDNs for living-donor kidney transplantation performed between January 2008 and December 2018 were evaluated. Hand port-site infections were identified in 92 HALDN cases. To investigate risk factors for hand port-site infection, donor characteristics, preoperative comorbidities, and operative factors were analyzed using logistic regression analysis.

*Results: In univariate analysis, significant differences in sex, smoking history, glucose intolerance, preoperative antibiotic prophylaxis, and prophylactic subcutaneous suction drain placement at the hand port-site were identified between the infection and no infection groups. In multivariate analysis, significant differences were identified between the two groups in sex (B=0.726, P=0.012, odds ratio [OR] 2.066, 95% confidence interval [CI] 1.169-3.652), preoperative antibiotic prophylaxis (B= -3.205, P<0.001, OR 0.041, 95% CI 0.013-0.122), and prophylactic subcutaneous suction drain placement at the hand port-site (B=0.689, P=0.022, OR 1.991, 95% CI 1.106-3.583). In subgroup analysis of donors with prophylactic subcutaneous suction drain placement, preoperative antibiotic prophylaxis was a significant factor in reducing the hand port-site infection incidence (B=-3.549, P<0.001, OR 0.029, 95% CI 0.006-0.128).

*Conclusions: Preoperative comorbidities may not cause hand port-site infections. Preoperative antibiotic prophylaxis, not prophylactic subcutaneous suction drain placement, is important for preventing hand port-site infection.

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To cite this abstract in AMA style:

Hiramitsu T, Tomosugi T, Futamura K, Okada M, Goto N, Ichimori T, Narumi S, Watarai Y. Preoperative Antibiotics Administration is Important to Prevent Hand Port-Site Infection After Hand-Assisted Laparoscopic Donor Nephrectomy for Living-Donor Kidney Transplantation [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/preoperative-antibiotics-administration-is-important-to-prevent-hand-port-site-infection-after-hand-assisted-laparoscopic-donor-nephrectomy-for-living-donor-kidney-transplantation/. Accessed May 28, 2025.

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