Surgical Outcome and Analysis of Risk of Complications in Kidney Donors Receiving Laparoscopic Live Donor Nephrectomy
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
Meeting: 2019 American Transplant Congress
Abstract number: B285
Keywords: Kidney, Laparoscopy, Risk factors, Surgical complications
Session Information
Session Name: Poster Session B: Kidney Living Donor: Selection
Session Type: Poster Session
Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Laparoscopic live donor nephrectomy has adopted for more than 20 years. But the operative procedure is still technically demanding, and allows almost no margin for error. To identify and analyze the risk of complications in donors, and to optimize the surgical outcome are most important. So the aim of the study is to review and analyze the outcome of donors receiving laparoscopic live donor nephrectomy in our hospital.
*Methods: The preoperative personal health profiles, harvested graft anatomy, surgical parameters, postoperative outcome, and at least 1-year follow-up of donors during November 2000 to April 2017 were retrospectively collected. Univariate and multivariate analyses were used to identify the risk factors predicting the occurrence of complications with more than CD grade II.
*Results: In the past 17 years, 347 donors received laparoscopic live donor nephrectomy either by totally laparoscopic (13%) or hand-assisted laparoscopic method (87%). Donor age (mean+SD) was 45.5+11.2 years, and female donor was about 65%. BMI was 23.9+3.7 kg/m2. Almost all the procedures (98.8%) accomplished with harvesting left-side kidney. 17% of graft kidneys has more than one renal artery, 9.2% has early branching of renal artery, and 10.1% has variations or early branching of renal vein. Mean operative time is 217.4+49.4 min. No procedure need to be converted to open method. Median blood loss is about 50 ml. Median postoperative hospital stay is 5 days. Complication rate (>CD grade II) is 4%, and reoperation rate is only 1.2%. No mortality occurred. The independent risk factors for predicting complications are donor age (odds ratio: 1.0755, 95% CI: 1.0146-1.1400, p=0.0143), and operative time (odds ratio: 1.0124, 95% CI: 1.0030-1.0218, p=0.0095). AUC=0.734. In another model, BMI <19 or > 26 is also an independent risk factor.
*Conclusions: Elder age, longer operative time mostly due to complex graft anatomy, and donors with abnormal BMI are risk factors predicting postoperative complications. The results helped us more careful when screening donors, and put more perioperative care if living kidney donors have these risk factors.
To cite this abstract in AMA style:
Yang C, Yeh C, Lee C, Chen C, Lai I, Lee P, Tsai M. Surgical Outcome and Analysis of Risk of Complications in Kidney Donors Receiving Laparoscopic Live Donor Nephrectomy [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/surgical-outcome-and-analysis-of-risk-of-complications-in-kidney-donors-receiving-laparoscopic-live-donor-nephrectomy/. Accessed May 11, 2025.« Back to 2019 American Transplant Congress