The Experience of 1000 Cases of Hand Assisted Laparoscopic Donor Nephrectomy for Living Donor Kidney Transplantation

T. Hiramitsu¹, T. Tomosugi¹, K. Futamura¹, M. Okada¹, N. Goto¹, S. Narumi¹, K. Uchida², Y. Watarai¹

¹Nagoya Daini Red Cross Hospital, Nagoya Aichi, Japan, ²Masuko Memorial Hospital, Nagoya Aichi, Japan

Meeting: 2020 American Transplant Congress

Abstract number: A-035

Keywords: Kidney transplantation, Living donor, Nephrectomy, Surgical complications

Session Information

Session Name: Poster Session A: 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: Due to the increasing number of kidney transplant candidates, living donor kidney transplantation becomes more necessary. For living donor kidney transplantation, safe and efficient donor nephrectomy is essential. Hand assisted laparoscopic donor nephrectomy (HALDN) is widely performed to lessen the burden of living donors. In this study, we investigated the the operative quality of right and left HALDN.

*Methods: Between January 2008 and August 2019, 1018 living kidney donors underwent HALDN. Left and right HALDN was indicated for 957 and 61 living kidney donors based on the results of the kidney function in the 99mTc-DTPA scintigraphy. Operative results of donors and recipients were compared between right and left HALDN.

*Results: Significat difference was not identified in age, sex, and body mass index between left and right HALDN. Operative duration and blood loss were similar in left and right HALDN (212.7±98.4 vs 211.0±42.6min, P=0.892, 95%CI -26.595-23.165; 33.5±60.3 vs 60.0±189.1ml, P=0.284, 95%CI -22.537-75.463). Warm ischemia time was significantly longer in right HALDN (133.6±69.4 vs 177.42.3 sec, P<0.001, 95%CI 26.479-61.766). Two and 1 open conversion were identified in left and right HALDN (P=0.169, OR 1.44 95%CI 0.634-9.142). The incidences of other postoperative complications including adhesive intestinal obstruction (2 vs 0, P=0.060), incisional hernia (5 vs 2, P=0.646 , OR 1.416, 95%CI 0.526-3.814), bleeding (2 vs 0, P>0.999), and wound infection (88 vs 4, P=0.646, OR 1.416, 95%CI 0.526-3.814) were similar in both groups. Post-operative estimated glomerular filtration rates (eGFRs) of living kidney donors were similar in both groups (Figure 1).

Only 1 delayed graft function was identified in the recipient transplanted kidney obtained by left HALDN.

*Conclusions: Left and right HALDN were performed in the similar quality except for the warm ischemia time without any serious complications.

To cite this abstract in AMA style:

Hiramitsu T, Tomosugi T, Futamura K, Okada M, Goto N, Narumi S, Uchida K, Watarai Y. The Experience of 1000 Cases of Hand Assisted Laparoscopic Donor Nephrectomy for Living Donor Kidney Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-experience-of-1000-cases-of-hand-assisted-laparoscopic-donor-nephrectomy-for-living-donor-kidney-transplantation/. Accessed May 12, 2025.

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