Laparoscopic (vs. open) live donor nephrectomy: A UNOS database analysis of early graft function and survival

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Abstract

The impact of laparoscopic (lap) live donor nephrectomy on early graft function and survival remains controversial. We compared 2734 kidney transplants (tx) from lap donors and 2576 tx from open donors reported to the U.S. United Network for Organ Sharing from 11/1999 to 12/2000. Early function quality (>40 mL urine and/or serum creatinine [creat] decline >25% during the first 24 h post-tx) and delayed function incidence were similar for both groups. Significantly more lap (vs. open) txs, however, had discharge creats greater than 1.4 mg/dL (49.2% vs. 44.9%, p = 0.002) and 2.0 mg/dL (21.8% vs. 19.5%, p = 0.04). But all later creats, early and late rejection, as well as graft survival at 1 year (94.4%, lap tx vs. 94.1%, open tx) were similar for lap and open recipients. Our data suggests that lap nephrectomy is associated with slower early graft function. Rejection rates and short-term graft survival, however, were similar for lap and open graft recipients. Further prospective studies with longer follow up are necessary to assess the potential impact of the laparoscopic procurement mode on early graft function and long-term outcome.

Original languageEnglish (US)
Pages (from-to)1295-1301
Number of pages7
JournalAmerican Journal of Transplantation
Volume3
Issue number10
DOIs
StatePublished - Oct 2003

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Graft Survival
Nephrectomy
Databases
Transplants
Creatinine
Urine
Prospective Studies
Kidney
Incidence
Serum

Keywords

  • Complications
  • Kidney graft function
  • Kidney transplantation
  • Laparoscopic nephrectomy
  • Live donor
  • Rejection

ASJC Scopus subject areas

  • Immunology

Cite this

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abstract = "The impact of laparoscopic (lap) live donor nephrectomy on early graft function and survival remains controversial. We compared 2734 kidney transplants (tx) from lap donors and 2576 tx from open donors reported to the U.S. United Network for Organ Sharing from 11/1999 to 12/2000. Early function quality (>40 mL urine and/or serum creatinine [creat] decline >25{\%} during the first 24 h post-tx) and delayed function incidence were similar for both groups. Significantly more lap (vs. open) txs, however, had discharge creats greater than 1.4 mg/dL (49.2{\%} vs. 44.9{\%}, p = 0.002) and 2.0 mg/dL (21.8{\%} vs. 19.5{\%}, p = 0.04). But all later creats, early and late rejection, as well as graft survival at 1 year (94.4{\%}, lap tx vs. 94.1{\%}, open tx) were similar for lap and open recipients. Our data suggests that lap nephrectomy is associated with slower early graft function. Rejection rates and short-term graft survival, however, were similar for lap and open graft recipients. Further prospective studies with longer follow up are necessary to assess the potential impact of the laparoscopic procurement mode on early graft function and long-term outcome.",
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