Long-Term Graft Function in a Randomized Clinical Trial Comparing Laparoscopic Versus Open Donor Nephrectomy

作者：Simforoosh Nasser^*; Basiri Abbas; Shakhssalim Nasser; Gooran Shahram; Tabibi Ali; Khoshdel Ali; Ziaee Seyed Amir Mohsen

来源：Experimental and Clinical Transplantation, 2012, 10(5): 428-432.

DOI：10.6002/ect.2012.0010

• Kidney transplant
• Laparoscopic donor nephrectomy
• Open donor nephrectomy
• Long-term follow-up

Objectives: To evaluate and compare the long-term graft and survival rates in kidney transplant recipients who had undergone laparoscopic donor nephrectomy versus those who underwent open donor nephrectomy.
Materials and Methods: Our study was done with 100 cases of laparoscopic donor nephrectomy and 100 cases of open donor nephrectomy, performed between July 2001 and September 2003. Mean follow-up of recipients in this study was 6.6 +/- 2.4 years (range, 1-9.3 y). This study has a longer follow-up than previous randomized clinical trials. We compared patient and graft survival in recipients of laparoscopic donor nephrectomy versus those who had open donor nephrectomy.
Results: Mean duration of kidney warm ischemia time was 8.7 +/- 2.7 minutes for laparoscopic donor nephrectomy and 1.8 +/- 0.92 minutes for open donor nephrectomy. There were no significant differences in 5-year graft survival between the laparoscopic donor nephrectomy and open donor nephrectomy groups (89.5% vs 84.3%; P = .96). There were no differences in delayed graft function between the laparoscopic donor nephrectomy and open donor nephrectomy groups (8 and 11 patients; P = .135). There was a significant difference in 5-year graft survival between recipients with a history of delayed graft function and those without delayed graft 63.2% vs 89.7%; P = .04). Despite a longer warm ischemia time in laparoscopic donor nephrectomy group (8.69 vs 1.87 min; P = .0001), warm ischemia time had no effect on graft outcome in long-term follow-up.
Conclusions: Although earlier experiences with laparoscopic donor nephrectomies were associated with concerns about long-term effects of laparoscopic donation on the graft function in the recipient, our long-term results confirm that laparoscopic donor nephrectomy provides similar graft outcome to open donor nephrectomy.

• 出版日期2012-10