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• W2038496985 abstract "No AccessJournal of UrologyReview article1 Nov 2007Open Versus Laparoscopic Live Donor Nephrectomy: A Focus on the Safety of Donors and the Need for a Donor Registry Ahmed A. Shokeir Ahmed A. ShokeirAhmed A. Shokeir More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.07.008AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A review of the existing literature showed that the subject of live donor nephrectomy is a seat of underreporting and underestimation of complications. We provide a systematic comparison between laparoscopic and open live donor nephrectomy with special emphasis on the safety of donors and grafts. Materials and Methods: The PubMed® literature database was searched from inception to October 2006. A comparison was made between laparoscopic and open live donor nephrectomy regarding donor safety and graft efficacy. Results: The review included 69 studies. There were 7 randomized controlled trials, 5 prospective nonrandomized studies, 22 retrospective controlled studies, 26 large (greater than 100 donors), retrospective, noncontrolled studies, 8 case reports and 1 experimental study. Most investigators concluded that, compared to open live donor nephrectomy, laparoscopic live donor nephrectomy provides equal graft function, an equal rejection rate, equal urological complications, and equal patient and graft survival. Analgesic requirements, pain data, hospital stay and time to return to work are significantly in favor of the laparoscopic procedure. On the other hand, laparoscopic live donor nephrectomy has the disadvantages of increased operative time, increased warm ischemia time and increased major complications requiring reoperation. In terms of donor safety at least 8 perioperative deaths were recorded after laparoscopic live donor nephrectomy. These perioperative deaths were not documented in recent review articles. Ten perioperative deaths were reported with open live donor nephrectomy by 1991. No perioperative mortalities have been recorded following open live donor nephrectomy since 1991. Regarding graft safety, at least 15 graft losses directly related to the surgical technique of laparoscopic live donor nephrectomy were found but none was emphasized in recent review articles. The incidence of graft loss due to technical reasons in the early reports of open live donor nephrectomy was not properly documented in the literature. Conclusions: We are in need of a live organ donor registry to determine the combined experience of complications and long-term outcomes, rather than short-term reports from single institutions. Like all other new techniques, laparoscopic live donor nephrectomy should be developed and improved at a few centers of excellence to avoid the loss of a donor or a graft. 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Google Scholar Urology and Nephrology Center, Mansoura University, Mansoura, Egypt© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHarper J, Breda A, Leppert J, Veale J, Gritsch H and Schulam P (2010) Experience With 750 Consecutive Laparoscopic Donor Nephrectomies—Is it Time to Use a Standardized Classification of Complications?Journal of Urology, VOL. 183, NO. 5, (1941-1946), Online publication date: 1-May-2010. Volume 178Issue 5November 2007Page: 1860-1866 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordskidneynephrectomyliving donorslaparoscopykidney transplantationMetrics Author Information Ahmed A. Shokeir More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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