Nephrol Dial Transplant (1999) 14: 2090-2093
© 1999 European Renal Association-European Dialysis and Transplant Association
Invited Comments
Laparoscopic live donor nephrectomy: the four year Johns Hopkins University experience
Departments of Surgery and Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Correspondence and offprint requests to: Lloyd E. Ratner, MD, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St./Harvey 611, Baltimore, MD 21287-8611, USA.
Introduction and rationale
Laparoscopic live donor nephrectomy is an operation that was designed specifically in an attempt to alleviate the profound shortage of kidneys for transplantation [1]. In the US, there is a growing disparity between the organ supply and demand. This has resulted in prolonged waiting times on the cadaveric renal transplant waiting list [2]. Commensurate with the increased waiting times has been an increase in the number of deaths of patients awaiting transplantation. Live kidney donors have remained an under-utilized source of transplantable organs.
Live donor renal transplantation offers several advantages over cadaveric transplantation. First, the long waiting times are eliminated. Second, there is a lower incidence of delayed function. Third, both patient and graft survival rates are significantly better with live donor transplantation [3]. Thus, not only are more organs made available, the need for repeat transplantation is reduced. Also, live donor renal transplantation
Technical considerations
Donor results
Theoretical considerations
Recipient results
Implications and spin-offs
Conclusions
References
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