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• W1985239043 abstract "No AccessJournal of UrologyAdult Urology1 Jun 2010Outcomes of Laparoscopic Donor Nephrectomy Without Intraoperative Systemic Heparinization Elaine Y. Cheng, David B. Leeser, Sandip Kapur, and Joseph Del Pizzo Elaine Y. ChengElaine Y. Cheng Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York More articles by this author , David B. LeeserDavid B. Leeser Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York Financial interest and/or other relationship with Novartis. More articles by this author , Sandip KapurSandip Kapur Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York More articles by this author , and Joseph Del PizzoJoseph Del Pizzo Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Intravenous heparin has traditionally been given during living donor laparoscopic nephrectomy despite the paucity of evidence supporting its use. We present the results of our experience with laparoscopic donor nephrectomy done without intraoperative systemic heparinization. Materials and Methods: We retrospectively reviewed the records of 167 consecutive laparoscopic donor nephrectomies done without intravenous heparin from July 2005 to October 2007 at our institution. We evaluated preoperative donor characteristics, intraoperative and postoperative complications, recipient renal function and graft outcomes. Results: All 138 left nephrectomies were done using a conventional laparoscopic approach while 25 of 29 right nephrectomies were done using the hand assisted technique. Warm ischemia time was approximately 3.0 minutes in each group. Mean ± SE estimated blood loss was 183 ± 29 ml for left and 115 ± 16 ml for right nephrectomy. Postoperatively hematocrit decreased an average of 4.5%. There were no intraoperative complications or open conversion requirements. The postoperative complication rate was 4.8%, including 2 patients (1.2%) in whom retroperitoneal hematoma developed. Only 1 of these patients (0.6%) required blood transfusion. Two grafts (1.2%) were lost due to vascular thrombosis in the immediate postoperative period and another 2 recipients experienced delayed graft function. Average 6, 12 and 24-month serum creatinine was 1.5, 1.5 and 1.6 mg/dl, respectively. Renal allograft survival was 97% 2 years after transplantation. Conclusions: Results indicate that laparoscopic donor nephrectomy can be successfully done without systemic heparinization with few donor complications, and excellent recipient graft survival and renal function up to 2 years after transplantation. References 1 : Comparison of open and laparoscopic live donor nephrectomy. Ann Surg1997; 226: 483. Google Scholar 2 : Laparoscopic living donor nephrectomy: a look at current trends and practice patterns at major transplant centers across the United States. J Urol2008; 179: 1488. Link, Google Scholar 3 : Use of heparin and protamine sulfate during laparoscopic donor nephrectomy. Transplantation2002; 74: 1700. Google Scholar 4 : Impact of intraoperative heparin on laparoscopic donor nephrectomy. J Urol2005; 174: 226. Link, Google Scholar 5 : Protamine and protamine reactions. Int Anesthesiol Clin2004; 42: 135. Google Scholar 6 : Laparoscopic donor nephrectomy 1997 to 2003: lessons learned with 500 cases at a single institution. Surgery2004; 136: 881. Google Scholar 7 : More than 500 consecutive laparoscopic donor nephrectomies without conversion or repeated surgery. Arch Surg2005; 140: 835. Google Scholar 8 : Laparoscopic donor nephrectomy: the University of Maryland 6-year experience. J Urol2004; 171: 47. Link, Google Scholar 9 : Laparoscopic live donor nephrectomy: trends in donor and recipient morbidity following 381 consecutive cases. Ann Surg2004; 240: 358. Google Scholar 10 : The first decade of a laparoscopic donor nephrectomy program: effect of surgeon and institution experience with 512 cases from 1996 to 2006. J Am Coll Surg2009; 209: 106. Google Scholar 11 : Laparoscopic versus open live donor nephrectomy in renal transplantation. Ann Surg2008; 247: 58. Google Scholar 12 : Living renal donor nephrectomy: evaluation of 135 cases. J Urol1973; 110: 639. Link, Google Scholar 13 : The value of systemic heparinization during living donor nephrectomy. Transplant Proc1990; 22: 346. Google Scholar © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRamasamy R, Afaneh C, Katz M, Chen X, Aull M, Leeser D, Kapur S and Del Pizzo J (2018) Comparison of Complications of Laparoscopic Versus Laparoendoscopic Single Site Donor Nephrectomy Using the Modified Clavien Grading SystemJournal of Urology, VOL. 186, NO. 4, (1386-1390), Online publication date: 1-Oct-2011. Volume 183Issue 6June 2010Page: 2282-2286 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordsheparinkidney transplantationnephrectomykidneyliving donorsMetricsAuthor Information Elaine Y. Cheng Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York More articles by this author David B. Leeser Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York Financial interest and/or other relationship with Novartis. More articles by this author Sandip Kapur Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York More articles by this author Joseph Del Pizzo Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W1985239043 title "Outcomes of Laparoscopic Donor Nephrectomy Without Intraoperative Systemic Heparinization" @default.
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