A Randomized, Prospective, Parallel Group Study of Laparoscopic Versus Laparoendoscopic Single Site Donor Nephrectomy for Kidney Donation

• Published in: American journal of transplantation Vol. 14; no. 7; pp. 1630 - 1637
• Main Authors: Aull, M. J., Afaneh, C., Charlton, M., Serur, D., Douglas, M., Christos, P. J., Kapur, S., Del Pizzo, J. J.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley 01.07.2014; Elsevier Limited
• Subjects: Biological and medical sciences; Digestive system. Abdomen; Donor nephrectomy; Endoscopy; Endoscopy - methods; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney Function Tests; Kidney Transplantation; laparoendoscopic; Laparoscopy; Laparoscopy - methods; Length of Stay - statistics & numerical data; Living Donors; Male; Medical sciences; Middle Aged; minimally invasive; Nephrectomy - methods; outcome; Postoperative Complications; Prognosis; Prospective Studies; randomized; single site nephrectomy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue and Organ Harvesting - methods; Site; Endoscopic surgery; Prognosis; Living donor; single site nephrectomy; Laparoscopy; minimally invasive; laparoendoscopic; Kidney; Prospective; Randomization; Treatment; Urinary system; Nephrectomy; Clinical trial; Evolution; Endoscopy; Organ harvesting; randomized; Comparative study; Donor nephrectomy; outcome
• ISSN: 1600-6135; 1600-6143; 1600-6143
• DOI: 10.1111/ajt.12735

Few prospective, randomized studies have assessed the benefits of laparoendoscopic single site donor nephrectomy (LESS‐DN) over laparoscopic donor nephrectomy (LDN). Our center initiated such a trial in January 2011, following subjects randomized to LESS‐DN versus LDN from surgery through 5 years postdonation. Subjects complete recovery/satisfaction questionnaires at 2, 6 and 12 months postdonation; transplant recipient outcomes are also recorded. One hundred subjects (49 LESS‐DN, 51 LDN) underwent surgery; donor demographics were similar between groups, and included a predominance of female, living‐unrelated donors, mean age of 47 years who underwent left donor nephrectomy. Operative parameters (overall time, time to extraction, warm ischemia time, blood loss) were similar between groups. Conversion to hand‐assist laparoscopy was required in 3 LESS‐DN (6.1%) versus 2 LDN (3.9%; p = 0.67). Questionnaires revealed that 97.2% of LESS‐DN versus 79.5% of LDN (p = 0.03) were 100% recovered by 2 months after donation. No significant difference was seen in satisfaction scores between the groups. Recipient outcomes were similar between groups. Our randomized trial comparing LESS donor nephrectomy to LDN confirms that LESS‐DN offers a safe alternative to conventional LDN in terms of intra‐ and post‐operative complications. LDN and LESS‐DN offer similar recovery and satisfaction after donation. In a randomized, prospective, parallel group study of laparoscopic versus laparoendoscopic single site donor nephrectomy in 100 kidney donors, the authors find that laparoendoscopic single site donor nephrectomy offers a safe alternative to conventional laparoscopic donor nephrectomy, with similar recovery and satisfaction after donation.