Laparoscopic Donor Nephrectomy with Terminal Hand Assisted Technique: Experience in 60 Donors and Recipients

Introduction: The limitation of cadaveric organ donations and the rapidly increasing number of patients with end stage renal disease awaiting kidney transplantation made living kidney donation indispensable. An important contribution to the revolution in living nephrectomy technique is hand assisted donor nephrectomy. Herein, we report our experience in hand assisted donor nephrectomy technique and its effect on the graft outcome. Methods: During the period from January 2012 till December 2015, 60 cases of hand-assisted laparoscopic donor nephrectomies were performed including 35 females and 25 males with a median age of 46.3±11.6 years. Results: Our mean operative donors' time was 93±21.8 minutes, and mean warm ischemia time was 48±9.1 seconds. Donor hospitalization time was between 3 and 5 days (mean 4 days). Follow up of the graft function after one year revealed mean serum creatinine of 1.56±1.03 mg/dl, mean GFR of 39.8±10.9 ml/min/1.73m and renal Doppler resistive index of 0.62±0.15. Conclusion: Laparoscopic donor nephrectomy with terminal hand assisted technique is a minimally invasive surgery that may improve donor acceptance and can become the procedure of choice in the near future. Also this technique has a good outcome concerning both warm ischemia time and graft outcome.