Retroperitoneoscopic Live-donor Right Nephrectomy: A Chinese Single Center

Abstract

Objectives: To evaluate our right-retro­peritoneoscopic live-donor nephrectomy by comparing the left side with the right side, and reporting our single-center experience for right-retroperitoneoscopic live-donor nephrectomy.

Patients and Methods: In China, live-kidney transplant is limited. It is even more essential now, because the deceased-donor kidney has become fewer after enacting the Chinese Regulation on Human Organ Transplantation. Therefore, there is a continued need to use the limited live-donor population. We chose 103 consecutive cases (84 left and 19 right) that underwent retroperitoneoscopic live-donor nephrectomy between December 2005 and December 2009, to compare the intraoperative and postoperative characteristics between the left and right sides, and report our experiences for 19 right-retroperitoneoscopic live-donor nephrectomies.

Results: All 84 left and 19 right-retro­peritoneoscopic live-donor nephrectomies were accomplished successfully without open conversion and transfusion. No significant differences were observed between the 2 groups regarding operative time, warm ischemia time, estimated blood loss, length of hospital stay, and serum creatinine level at discharge (Table 1). Eight of the donors and 3 of the grafts had minor complications that were all resolved with conservative treatment. The recipients’ serum creatinine levels at 1 day and 1 month after surgery were the same in both groups. No acute renal tubule necrosis or delayed graft function was observed in the recipients.

Conclusions: Our right-retroperitoneoscopic live-donor nephrectomy achieves comparable outcomes with the left side and proves to be a feasible, cost-effective, safe, and minimally invasive alternative for live-kidney donation. This maximally uses the innately limited donors and potentially increases the donor pool in China.