Five-Year Experience of Adoption and Evolution of Laparoscopic Living Donor Nephrectomy

Results From a Center Without Large Volume of Patients

Chung-Jye Hung, Yih-Jyh Lin, Shen-Shun Chang, Tsung-Ching Chou, J. P. Chuang, P. Y. Chung, Y. S. Lin, P. C. Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: Despite the advantages of laparoscopic living donor nephrectomy (LDN), this technique is known to have a steep learning curve that makes worldwide adoption challenging, especially in institutions without a large patients volume. Herein, we have reviewed our 5-year experience of adoption and evolution of this surgical technique, examining the donor and recipient outcomes. Methods: Between September 2002 and June 2007, 40 LDNs were performed consecutively. Our surgical technique was mainly derived from the University of California San Francisco method. We retrospectively reviewed the donor demographics, operative characteristics, perioperative complication of donors/recipients, and outcomes of donors and recipients. Results: Among the 40 cases, 36 (90.0%) were left-sided LDNs. Mean operative time was 335.1 ± 66.9 minutes, blood loss was 303.9 ± 333.2 mL, and warm ischemia time was 243.2 ± 127.0 seconds. Multiple renal arteries required bench arterial reconstruction in 7 (17.5%) donor kidneys. Three renovascular injuries occurred intraoperatively, and 2 (5.0%) required open conversion. The overall postoperative complication rate was 20.0%. Postoperative donor serum creatinine was 1.5 times higher than preoperative serum creatinine. All but one recipient was discharged with adequate renal function. Graft function continues in 36 of the 38 harvested kidneys (94.7%) during the follow-up period. One (2.5%) recipient developed ureteral necrosis, and no recipients developed vascular thrombosis. Conclusions: LDNs can be performed with careful adoption and evolution in institutions without a large patient volume. The intraoperative complication rate of LDN can be reduced with experience.

Original languageEnglish
Pages (from-to)2112-2114
Number of pages3
JournalTransplantation Proceedings
Volume40
Issue number7
DOIs
Publication statusPublished - 2008 Sep 1

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Living Donors
Nephrectomy
Tissue Donors
Kidney
Creatinine
Warm Ischemia
Learning Curve
San Francisco
Intraoperative Complications
Renal Artery
Operative Time
Serum
Blood Vessels
Thrombosis
Necrosis
Demography
Transplants
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

@article{dc8eea7706a34b9fa354678962f4f8b5,
title = "Five-Year Experience of Adoption and Evolution of Laparoscopic Living Donor Nephrectomy: Results From a Center Without Large Volume of Patients",
abstract = "Objectives: Despite the advantages of laparoscopic living donor nephrectomy (LDN), this technique is known to have a steep learning curve that makes worldwide adoption challenging, especially in institutions without a large patients volume. Herein, we have reviewed our 5-year experience of adoption and evolution of this surgical technique, examining the donor and recipient outcomes. Methods: Between September 2002 and June 2007, 40 LDNs were performed consecutively. Our surgical technique was mainly derived from the University of California San Francisco method. We retrospectively reviewed the donor demographics, operative characteristics, perioperative complication of donors/recipients, and outcomes of donors and recipients. Results: Among the 40 cases, 36 (90.0{\%}) were left-sided LDNs. Mean operative time was 335.1 ± 66.9 minutes, blood loss was 303.9 ± 333.2 mL, and warm ischemia time was 243.2 ± 127.0 seconds. Multiple renal arteries required bench arterial reconstruction in 7 (17.5{\%}) donor kidneys. Three renovascular injuries occurred intraoperatively, and 2 (5.0{\%}) required open conversion. The overall postoperative complication rate was 20.0{\%}. Postoperative donor serum creatinine was 1.5 times higher than preoperative serum creatinine. All but one recipient was discharged with adequate renal function. Graft function continues in 36 of the 38 harvested kidneys (94.7{\%}) during the follow-up period. One (2.5{\%}) recipient developed ureteral necrosis, and no recipients developed vascular thrombosis. Conclusions: LDNs can be performed with careful adoption and evolution in institutions without a large patient volume. The intraoperative complication rate of LDN can be reduced with experience.",
author = "Chung-Jye Hung and Yih-Jyh Lin and Shen-Shun Chang and Tsung-Ching Chou and Chuang, {J. P.} and Chung, {P. Y.} and Lin, {Y. S.} and Lee, {P. C.}",
year = "2008",
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day = "1",
doi = "10.1016/j.transproceed.2008.07.047",
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T1 - Five-Year Experience of Adoption and Evolution of Laparoscopic Living Donor Nephrectomy

T2 - Results From a Center Without Large Volume of Patients

AU - Hung, Chung-Jye

AU - Lin, Yih-Jyh

AU - Chang, Shen-Shun

AU - Chou, Tsung-Ching

AU - Chuang, J. P.

AU - Chung, P. Y.

AU - Lin, Y. S.

AU - Lee, P. C.

PY - 2008/9/1

Y1 - 2008/9/1

N2 - Objectives: Despite the advantages of laparoscopic living donor nephrectomy (LDN), this technique is known to have a steep learning curve that makes worldwide adoption challenging, especially in institutions without a large patients volume. Herein, we have reviewed our 5-year experience of adoption and evolution of this surgical technique, examining the donor and recipient outcomes. Methods: Between September 2002 and June 2007, 40 LDNs were performed consecutively. Our surgical technique was mainly derived from the University of California San Francisco method. We retrospectively reviewed the donor demographics, operative characteristics, perioperative complication of donors/recipients, and outcomes of donors and recipients. Results: Among the 40 cases, 36 (90.0%) were left-sided LDNs. Mean operative time was 335.1 ± 66.9 minutes, blood loss was 303.9 ± 333.2 mL, and warm ischemia time was 243.2 ± 127.0 seconds. Multiple renal arteries required bench arterial reconstruction in 7 (17.5%) donor kidneys. Three renovascular injuries occurred intraoperatively, and 2 (5.0%) required open conversion. The overall postoperative complication rate was 20.0%. Postoperative donor serum creatinine was 1.5 times higher than preoperative serum creatinine. All but one recipient was discharged with adequate renal function. Graft function continues in 36 of the 38 harvested kidneys (94.7%) during the follow-up period. One (2.5%) recipient developed ureteral necrosis, and no recipients developed vascular thrombosis. Conclusions: LDNs can be performed with careful adoption and evolution in institutions without a large patient volume. The intraoperative complication rate of LDN can be reduced with experience.

AB - Objectives: Despite the advantages of laparoscopic living donor nephrectomy (LDN), this technique is known to have a steep learning curve that makes worldwide adoption challenging, especially in institutions without a large patients volume. Herein, we have reviewed our 5-year experience of adoption and evolution of this surgical technique, examining the donor and recipient outcomes. Methods: Between September 2002 and June 2007, 40 LDNs were performed consecutively. Our surgical technique was mainly derived from the University of California San Francisco method. We retrospectively reviewed the donor demographics, operative characteristics, perioperative complication of donors/recipients, and outcomes of donors and recipients. Results: Among the 40 cases, 36 (90.0%) were left-sided LDNs. Mean operative time was 335.1 ± 66.9 minutes, blood loss was 303.9 ± 333.2 mL, and warm ischemia time was 243.2 ± 127.0 seconds. Multiple renal arteries required bench arterial reconstruction in 7 (17.5%) donor kidneys. Three renovascular injuries occurred intraoperatively, and 2 (5.0%) required open conversion. The overall postoperative complication rate was 20.0%. Postoperative donor serum creatinine was 1.5 times higher than preoperative serum creatinine. All but one recipient was discharged with adequate renal function. Graft function continues in 36 of the 38 harvested kidneys (94.7%) during the follow-up period. One (2.5%) recipient developed ureteral necrosis, and no recipients developed vascular thrombosis. Conclusions: LDNs can be performed with careful adoption and evolution in institutions without a large patient volume. The intraoperative complication rate of LDN can be reduced with experience.

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U2 - 10.1016/j.transproceed.2008.07.047

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JF - Transplantation Proceedings

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