Başkent Üniversitesi Makaleler

Permanent URI for this collectionhttps://hdl.handle.net/11727/13096

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Author: search.filters.author.Crane, Jeremy

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    Safety of Nephrectomy in Morbidly Obese Donors
    (Başkent Üniversitesi, 2012-12) O’Brien, Benjamin; Papalois, Vassilios; Hakim, Nadey; Crane, Jeremy; Mastoridis, Sotiris
    Objectives: To satisfy donor organ shortage, overweight and obese donors are becoming a greater proportion of the kidney donor pool. Although good safety data exist in overweight and moderately obese individuals (body mass index = 25 to 35 kg/m2), there is little information about outcomes in morbidly obese donors (body mass index ≥ 40 kg/m2). The purpose of this study was to review the experience with morbidly obese donors in a single center and assist in the discussion about the feasibility of nephrectomy in such cases. Materials and Methods: Outcomes of nephrectomy in morbidly obese donors between January 2005 and June 2010 were reviewed retrospectively and compared with outcomes in nonobese donors. Results: Of 386 nephrectomies, 7 involved morbidly obese donors. Mortality and major complication rates were low in all body mass index categories. A high incidence of minor postoperative complications was observed in the morbidly obese, with 57% morbidly obese patients requiring treatment for complications including respiratory infection, compared with 30% in nonobese donors (P < .05). There were no significant differences in mean operative time, estimated blood loss, and length of hospital stay between all body mass index categories. Limited follow-up data (mean, 20 mo) showed similar renal function parameters between groups. Conclusions: The limited data suggest that nephrectomy may be feasible in selected morbidly obese donors. Further study is needed before major conclusions can be made.
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    Mini-Incision Donor Nephrectomy Techniques: A Systematic Review
    (Başkent Üniversitesi, 2010-06) Aboutaleb, Esam; Hakim, Nadey; Crane, Jeremy; Herbert, Paul
    Objectives: The aim of this article is to compare different mini-incision donor nephrectomy techniques in the literature. Materials and Methods: We did a literature search using PUBMED using the search term “donor nephrectomy.” We compared different surgical techniques using different parameters like length of incision, length of operation, pain medications required after the operation, site of the operation, and intraoperative and postoperative complications. Results: We found 7 different surgical techniques of mini-invasive donor nephrectomy. Hakim and associates described the smallest initial incision size of 4 cm. There also are limited data on the analgesia requirements in 4 of the series, and 3 series that describe the requirements vary. Conclusions: These techniques offer advantages and disadvantages to the donor and the kidney. We hope to encourage further work. Ideally, there must be a working discussion, long-term outcomes of donor kidney and recipient, as well as accurate pain records, both quantitative and qualitative, and a discussion of time to mobilization.