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Type: Journal article
Title: A systematic review of laparoscopic live-donor nephrectomy
Author: Tooher, R.
Rao, M.
Scott, D.
Wall, D.
Francis, D.
Bridgewater, F.
Maddern, G.
Citation: Transplantation, 2004; 78(3):404-414
Publisher: Lippincott Williams & Wilkins
Issue Date: 2004
ISSN: 0041-1337
Statement of
Rebecca L. Tooher, M. Mohan Rao, David F. Scott, Daryl Wall, David M.A. Francis, Franklin H.G. Bridgewater and Guy J. Maddern
Abstract: <h4>Background</h4>A systematic review was undertaken to assess the safety and efficacy of laparoscopic live-donor nephrectomy (LLDN) compared with open live-donor nephrectomy (OLDN).<h4>Methods</h4>Literature databases were searched from inception to March 2003 inclusive. Comparative studies of LLDN versus OLDN (randomized and nonrandomized) were included.<h4>Results</h4>There were 44 included studies, and the quality of the available evidence was average. There was only one randomized controlled trial and six nonrandomized comparative studies with concurrent controls identified. In terms of safety, for donors, there did not seem to be any distinct difference between the laparoscopic and open approaches. No donor mortality was reported for either procedure, and the complication rates were similar although the types of complications experienced differed between the two procedures. The conversion rate for LLDN to an open procedure ranged from 0% to 13%. In terms of efficacy, LLDN seemed to be a slower operation with longer warm ischemia times than OLDN, but this did not seem to have resulted in increased rates of delayed graft function for recipients. Donor postoperative recovery and convalescence seemed to be superior for LLDN, making it a potentially more attractive operation for living donors. Although in the short-term, graft function and survival did not seem to differ between the two techniques, long-term complication rates and allograft function could not be determined and further long-term follow-up is required.<h4>Conclusions</h4>LLDN seems to be at least as safe and efficacious as OLDN in the short-term. However, it remains a technique in evolution. Further high-quality studies are required to resolve some of the outstanding issues surrounding its use, in particular, long-term follow-up of donor complications and recipient graft function and survival.
Keywords: Live-donor
Living donor
Laparoscopic donor nephrectomy
Kidney transplantation
Rights: (C) 2004 Lippincott Williams & Wilkins, Inc.
DOI: 10.1097/01.TP.0000128638.85491.76
Appears in Collections:Aurora harvest 2
Surgery publications

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