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NDT Advance Access originally published online on October 12, 2004
Nephrology Dialysis Transplantation 2004 19(12):2961-2964; doi:10.1093/ndt/gfh510
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Nephrol Dial Transplant Vol. 19 No. 12 © ERA-EDTA 2004; all rights reserved

Editorial Comment

Laparoscopic live donor nephrectomy

Ben Challacombe and Nizam Mamode

Department of Transplantation, Guy's Hospital, London, UK

Correspondence and offprint requests to: Mr Nizam Mamode, Clinical Transplantation, New Guy's House, Guy's Hospital, London SE1 9RT, UK. Email: Nizam.Mamode@gstt.sthames.nhs.uk

Keywords: laparoscopy; live donor nephrectomy

The first 150 words of the full text of this article appear below.



   Background
 
Traditional open living donor nephrectomy (ODN) is a safe procedure with a mortality of 0.03% [1]. However, there is significant donor morbidity with acute and chronic wound pain, wound infection, prolonged hospital stay, late return to full activity and a risk of incisional herniae. Laparoscopic live donor nephrectomy (LLDN) was introduced <10 years ago in an attempt to minimize these complications, but concerns have been raised about the security of the technique for both donor and recipient, and whether it offers sufficient benefit over modern open techniques, including mini-incision nephrectomy. LLDN remains a technically difficult and complex operation, scoring 16 out of 21 for difficulty in the European Scoring System for Laparoscopic Operations [2].



   Techniques
 
LLDN was first described at Johns Hopkins University by Ratner et al. in 1995 [3] on a 40-year-old man with good results. It may be performed using the hand-assisted method . . . [Full Text of this Article]



   Laparoscopic donor nephrectomy vs open surgery
 


   Costs
 


   Complications of laparoscopic live donor nephrectomy
 
Ureteric complications
Graft function
Other complications


   Right-sided donor nephrectomy
 


   Multiple arteries
 


   Hand-assisted vs ‘pure’ laparoscopic nephrectomy
 


   Training
 


   Conclusions
 

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