NDT Advance Access originally published online on May 15, 2006
Nephrology Dialysis Transplantation 2006 21(9):2563-2568; doi:10.1093/ndt/gfl207
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Original Articles: Dialysis and Transplantation
Open and laparoscopic living donor nephrectomy in Switzerland: a retrospective assessment of clinical outcomes and the motivation to donate
1 Department of Visceral and Transplantation Surgery, University Hospital Zurich, Rämistr. 100, CH-8091 Zurich, Switzerland, 2 Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, 515 W Lombard Street, Baltimore, MD 21201-1563, USA, 3 Division of Nephrology, University Children's Hospital Zurich, Steinwiesstr. 75, CH-8032 Zurich, 4 Department of Nephrology, University Hospital Zurich, Rämistr. 100, CH-8091 Zurich, 5 Swiss Organ Living-Donor Health Registry, Division of Nephrology, University Hospital Basel, Petersgraben 4, CH-4056 Basel, Switzerland
Correspondence and offprint requests to: Markus Weber, MD, Department of Visceral and Transplantation Surgery, University Hospital Zurich, Rämistr. 100, CH-8091 Zurich, Switzerland. Email: markus.weber{at}usz.ch
Background. Laparoscopic living kidney nephrectomy is thought to be associated with reduced morbidity, when compared to open nephrectomy. The purpose of this study was to explore the impact of these techniques on donors’ clinical outcomes, satisfaction and motivation to donate.
Methods. Clinical outcomes were retrospectively compared in 152 open (n = 71) or laparoscopic (n = 81) donor procedures. Donor satisfaction and motivation were assessed with a self-administered questionnaire.
Results. The complication rate was the same with both procedures and the majority of complications were mild. Laparoscopy was significantly less painful and resulted in an insignificantly faster return to active life. More than 80% of the donors volunteered to donate without pressure. Worries about future health status, pain or scars were not important in the decision to donate. Similarly, only 15% considered the surgical procedure as instrumental for their decision. Few donors currently worried about their health with one kidney and more than 95% of the donors in both groups stated that they would give their kidney again.
Conclusions. Living donor nephrectomy is safe, regardless of the procedure used. Although the laparoscopic nephrectomy offers clear short-term benefits over the open nephrectomy, donors’ satisfaction was excellent with both surgical approaches. Moreover, the type of procedure did not seem to influence their decision to donate.
Keywords: kidney transplantation; laparoscopy; living donors; personal satisfaction; motivation; quality of life