Robot-assisted laparoscopic and open live-donor nephrectomy: a comparison of donor morbidity and early renal allograft outcomes

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2006-02, Vol.21 (2), p.472-477
• Main Authors: Renoult, Edith, Hubert, Jacques, Ladrière, Marc, Billaut, Nicolas, Mourey, Eric, Feuillu, Benoît, Kessler, Michèle
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Emergency and intensive care: renal failure. Dialysis management; Female; Humans; Intensive care medicine; Intraoperative Complications - epidemiology; kidney graft function; Kidney Transplantation; Laparoscopy - methods; live donor; Living Donors; Male; Medical sciences; minimally invasive surgical techniques; Nephrectomy - methods; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Postoperative Complications - epidemiology; Renal failure; Retrospective Studies; robot-assisted laparoscopic live donor nephrectomy; Robotics; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Tissue and Organ Harvesting - adverse effects; Tissue and Organ Harvesting - methods; Treatment Outcome
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfi150

Background. Robot-assisted laparoscopic donor (RALD) nephrectomy, a new procedure for the removal of a kidney from a living donor, was performed on 13 subjects at our centre. Methods. The immediate post-operative courses for these donors, and their respective recipients, were compared with those of 13 previous open live-donor nephrectomies (OPEN), performed in our facility. Results. We found no significant differences between these two donor groups with respect to age, gender, body mass index or renal vasculature. The average operative times and the warm ischaemia times were greater in the RALD group, 185.5″ vs 113.4″ (P = 0.0001) and 7′15″ vs 1′41″ (P = 0.0001), respectively. There was no conversion to the open procedure in the RALD group. The estimated blood loss was slight in both groups. Following nephrectomy, deep venous thrombosis occurred in one RALD patient and acute pyelonephritis in one OPEN patient. The average duration of hospitalization was shorter after the RALD procedure (5.84±1.8 days vs 9.69±2.2 days, P = 0.0001). The estimated creatinine clearance rate (eClcreat) was equivalent for all donors, at 5 days and 1 month after nephrectomy. All kidneys started functioning immediately after the transplantation. The mean recipient eClcreat (ml/min) was 58.16±26.7 for OPEN group kidneys and 62.23±17.59 for RALD group kidneys (P = 0.65), 5 days after transplantation. Conclusions. RALD nephrectomies were associated with very low morbidity among donors, in which both the operative and warm ischaemia times were of longer duration, but had no observable adverse effects upon short-term graft function.