NDT Advance Access originally published online on October 4, 2005
Nephrology Dialysis Transplantation 2006 21(2):472-477; doi:10.1093/ndt/gfi150
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© The Author [2005]. 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
Robot-assisted laparoscopic and open live-donor nephrectomy: a comparison of donor morbidity and early renal allograft outcomes
1 Department of Nephrology and 2 Department of Urology, University Hospital of Nancy, France
Correspondence and offprint requests to: Edith Renoult, Department of Nephrology, University Hospital of Nancy, Rue du Morvan, 54511– Vandoeuvre-les-Nancy, France. Email: erenoult{at}msn.com
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.
Keywords: kidney graft function; live donor; minimally invasive surgical techniques; robot-assisted laparoscopic live donor nephrectomy; robotics