Laparoscopic Donor Nephrectomy - The MPUH experience

Laparoscopic live donor [LDN] nephrectomy has the advantages of reduced pain and shorter recuperation for the donor without compromising the out come in the recipient. Gill et.al. demonstrated the feasibility of performing LDN in porcine model and thereafter Ratner et.al. reported the first successful human laparoscopic LDN . We started doing LDN at out institute in November 2002.
50 donors were subjected to left nephrectomy and standard transperitoneal laproscopic technique was followed with 3 ports in 7 and 4 in 43 patients.
Donor parameters evaluated were operative time; warm ischemia [WIT] and total ischemia time [TIT]; HCT drop;
analgesia required; start of orals; days of hospitalization; post op complications.
Mean age was 44yrs Average WIT was 7 min. [4-11min.] and TIT was 52 min. [39-79 min.]; Average laparoscopy time was 176 min. [90-270min.]; average drop in haematocrit was 3.7% [1-8%] with only one patient requiring transfusion. None of the donors needed conversion to open surgery. Intra operative complications seen were lumbar vessel bleed in 2 and splenic capsular tear in 1. All were managed laparoscopically. Mild surgical emphysema was seen in 2 patients in postoperative period.
Average hospital stay was 3 days [2-6 days].
Laproscopic live donor nephrectomy is safe, effective procedure with minimal morbidity for the donor. All the recipients had immediate urine output and good early graft function.
Trans peritoneal port placement
for live donor nephrectomy
Renal hilum seen preoperatively.