Session Name: Kidney Technical
Session Date & Time: None. Available on demand.
*Purpose: Due to the profound organ shortage, living donor kidney transplantation becomes more necessary. Hand assisted laparoscopic donor nephrectomy (HALDN) is widely performed to lessen the burden of living donors. However, efficient and safe donor nephrectomy is essential. We investigated the efficacy and safety of right and left HALDN.
*Methods: Between January 2008 and August 2019, 1018 living kidney donors underwent HALDN. Left and right HALDN were 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 group.
*Results: Significat difference was not identified in donor characteristics between left and right HALDN group. Operative duration and blood loss were similar in left and right HALDN group (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 group (133.6±69.4 vs 177.42.3 sec, P<0.001, 95%CI 26.479-61.766). Two and one open conversion were identified in left and right HALDN group (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 of living kidney donors were similar in both groups.
Post-operative estimated glomerular filtration rates of recipients were similar in both groups.
Only 1 delayed graft function due to the arterial injury during the left HALDN was identified.
*Conclusions: The efficacy and safety of left and right HALDN were demonstrated through our experience of 1000 cases.
To cite this abstract in AMA style:Hiramitsu T, Tomosugi T, Futamura K, Okada M, Goto N, Ichimori T, Narumi S, Watarai Y. The Experience of 1000 Hand Assisted Laparoscopic Donor Nephrectomy for Living Donor Kidney Transplantation [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/the-experience-of-1000-hand-assisted-laparoscopic-donor-nephrectomy-for-living-donor-kidney-transplantation/. Accessed June 12, 2021.
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