Retroperitoneoscopic donor nephrectomy: a retrospective, non-randomized comparison of early complications, donor and recipient outcome with the standard open approach.

Objectives: We retrospectively performed a comparative analysis of retroperitoneoscopic and open donor nephrectomy in terms of donor complications, as well as recipient complications and functional graft outcome.

Methods: A total of 134 donor nephrectomies including 69 open (ODN) and 65 retroperitoneoscopic (RDN) nephrectomies was analyzed retrospectively. Both groups were comparable in terms of age, body mass index (BMI), operating time (OPT), warm ischemia time (WIT) and blood loss.

Results: There were no statistically significant differences with respect to recipient outcome, mean values for age, BMI, OPT and cold ischemia time (CIT). The overall donor complication rate did not differ. Early functional graft follow-up showed significant differences in 24 h-urine output between the two groups (p<0.001), but serum creatinine was comparable after 7, 30, 180 and 365 days. The early rejection rate in the recipients was similar in the two groups.

Conclusion: Retroperitoneoscopic donor nephrectomy (RDN) provides comparable perioperative features, such as operating time, warm ischemia time (WIT) and overall complication rate to the open donor nephrectomy (ODN). Additionally, it has no negative impact on recipients' operating time, graft ischemia and early graft function.