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Laparoscopic donor nephrectomy: an update

Kieran, Kathleen; Roberts, William W

Current Opinion in Nephrology and Hypertension: November 2005 - Volume 14 - Issue 6 - p 599–603
doi: 10.1097/01.mnh.0000170750.18409.96
Diagnostic and techniques

Purpose of review Laparoscopic donor nephrectomy is considered the gold standard for renal donation. In the hands of experienced laparoscopists it provides a safe and equally effective alternative to open nephrectomy, and recipient graft function has been shown to be equivalent regardless of the procurement method utilized. Complication rates and postoperative donor renal function are equivalent to that of open nephrectomy, whereas recovery time is significantly shorter and surgical scars more cosmetic with the laparoscopic approach.

Recent findings Advances in preoperative imaging and laparoscopic technique have enabled surgeons to broaden the patient population considered for donor nephrectomy. Improved three-dimensional imaging facilitates operative planning and intraoperative dissection, and the retroperitoneoscopic approach has decreased operative time. Acquisition of laparoscopic skills has also enabled surgeons to perform donor nephrectomies on kidneys that previously would have been considered less desirable for donation (e.g. right-sided or with anomalous vasculature).

Summary End-stage renal disease and the need for renal transplantation continue to be major medical concerns in the United States and worldwide. Advances in donor nephrectomy have reduced the demand for organs by increasing the potential organ pool while limiting risk to donors. As imaging and laparoscopic techniques continue to advance, it is anticipated that minimally invasive donor nephrectomy will continue to evolve. This review summarizes the developments to date.

University of Michigan Urology Center, Ann Arbor, Michigan, USA

Correspondence to Dr K. Kieran, University of Michigan Health System, Department of Urology, 1500 East Medical Center Drive, TC 3875, Ann Arbor, MI 48109, USA Tel: +1 734 615 0563; fax: +1 734 936 9127; e-mail: kkieran@med.umich.edu

© 2005 Lippincott Williams & Wilkins, Inc.