AI Article Synopsis
- This study analyzes trends in surgical methods, hospital stay length, and mortality rates for kidney transplants (KT) and living donor nephrectomies (LDN) in Germany from 2006 to 2021.
- Key findings show a decrease in open LDN procedures from 82% to 22%, with laparoscopic methods rising significantly, while robotic LDN began to emerge.
- Overall, living donor KT had a shorter hospital stay compared to donations after brain death, and in-hospital mortality rates were low, though caution is advised due to the rare deaths of healthy donors following LDN.
Article Abstract
Purpose: To analyze recent trends of surgical access routes, length of hospital stay (LOS), and mortality in kidney transplantation (KT) and living donor nephrectomy (LDN) in Germany.
Materials And Methods: We studied the nationwide German hospital billing database and the German hospital quality reports from 2006 to 2021.
Results: There were a total of 35.898 KTs. In total, 9044 (25%) were living donor transplantations, while 26.854 (75%) were transplantations after donation after brain death (DBD). The share of open LDN decreased from 82% in 2006 to 22% in 2020 (- 4%/year; p < 0.001). The share of laparoscopic LDN increased from 18% in 2006 to 70% in 2020 (+ 3%/year; p < 0.001). The share of robotic LDN increased from 0% in 2006 to 8% in 2020 (+ 0.6%/year; p < 0.001). Robotic-assisted KT increased from 5 cases in 2016 to 13 procedures in 2019 (p = 0.2). LOS was shorter after living donor KT, i.e., 18 ± 12.1 days versus 21 ± 19.6 days for DBD renal transplantation (p < 0.001). Moreover, LOS differed for open versus laparoscopic versus robotic LDN (9 ± 3.1 vs. 8 ± 2.9 vs. 6 ± 2.6; p = 0.031). The overall in-hospital mortality was 0.16% (n = 5) after LDN, 0.47% (n = 42) after living donor KT and 1.8% (n = 475) after DBD KT.
Conclusions: There is an increasing trend toward minimal-invasive LDN in recent years. Overall, in-hospital mortality was low after KT. However, 5 deceased healthy donors after LKD caution that the risks of this procedure should also be taken very seriously.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10781803 | PMC |
| http://dx.doi.org/10.1007/s00345-023-04737-w | DOI Listing |
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