Klinisch II - P29 - Influence of donor factors and operative technique on surgical out­come in a cohort comprising 18 years of mini-incision and laparo­scopic kidney donation

K. Ramdhani, G. Haasnoot, A.E. Braat, A.G. Baranski, V.A.L. Huurman

Chair(s): dr. Arjan van Zuilen, UMCU

Thursday 10 march 2016

13:30 - 14:00h at Foyer

Categories: Postersessie

Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)

While laparoscopic live kidney donation (LDN) has been increasingly performed in recent years, mini incision donor nephrectomy (MDN) remains a known safe and feasible option for live kidney donation. Aim of the present study was to describe the outcome of both techniques as practiced in our center, and to identify possible factors that may influence these outcomes.

A cohort of 836 live kidney donors (702 MDN, 134 LDN) undergoing live kidney donation between May 1997 and May 2015 was retrospectively analyzed. Primary outcome was occurrence of any major or minor complication during initial hospitalization, secondary measures included perioperative blood loss, operating time and hospital stay. Factors included in the analysis were donor age, BMI, kidney side and operative technique.

In our cohort, the overall incidence of any complication was 10.3%, with 5 patients (0.6%) needing reintervention. No mortality was observed. In univariate analysis, there was no significant difference in complication rate between MDN and LDN (10.8% vs 7.5%). Surprisingly, patients aged <60 tended to have more complications (11.9% vs 8.2%, p=0.09). The subgroup of patients with high BMI showed a significantly higher complication rate in left kidney donation ( 13.1% vs 3.9%, p=0.019).
In multivariate logistic regression analysis, left kidney donation and age <60 were significantly associated with a higher complication rate (OR 2.6 and 1.6, respectively). Secondary outcomes included significantly less blood loss (109 vs 307 ml), longer operating time (221 vs 198 min) and shorter hospital stay (4 vs 5 days) in LDN when compared to MDN. BMI, age and kidney side were not of significant influence.

MDN and LDN are both safe options for live kidney donation, with limited complication rate. The data in our cohort show an association between kidney side and age on complications. Although retrospectively analyzed, these results may help in clinical decision making when selecting kidney side and operative technique in living donor retrieval surgery.