AI Article Synopsis
- Surgeons prefer left kidneys for living donor transplants; this study compares outcomes of left versus right kidney donations.
- Analysis of 7919 nephrectomy and transplantation cases showed right kidney donations had more surgical site infections among donors and poorer immediate outcomes for recipients.
- Laparoscopic surgery was associated with fewer complications and better long-term graft survival than open surgery, highlighting the importance of surgical technique.
Article Abstract
Background: In living donor renal transplantation, surgeons traditionally prefer the left kidney for donation. The aim of this study was to assess the effects of the choice of laterality of donor nephrectomy on donor and recipient outcomes.
Methods: The data was obtained from the UK National Health Service Blood and Transplant (NHSBT). During the study period, 7919 donor nephrectomy and transplantation were carried out in 24 transplant centers. Of these procedures, 6407 (80.9%) were left and 1512 (19.1%) were right kidney donors.
Results: Right kidney donation was associated with higher incidence of surgical site infection in the donor. Recipient outcome was superior for left-sided kidneys in terms of immediate graft function, delayed graft function, graft loss within 30 days, and graft survival at 3 years, but not at 1 and 5 years. Open donor nephrectomy (n = 2396, 30.2%) was associated with higher rates of pneumothorax and hemorrhage, longer hospital stay, and inferior graft survival at 3 and 5 years compared with laparoscopic donor nephrectomy (n = 5523, 69.8%).
Conclusions: A right donor nephrectomy is associated with higher rate of wound infection in the donor and similar long-term graft outcomes in the recipients. Laparoscopic donor nephrectomy offers lower rate of major complications in the donor and a better overall graft survival.
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| http://dx.doi.org/10.1016/j.transproceed.2021.06.011 | DOI Listing |
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