%0 Journal Article
%T Impact of Right-Sided Nephrectomy on Long-Term Outcomes in Retroperitoneoscopic Live Donor Nephrectomy at Single Center
%A Kazuya Omoto
%A Taiji Nozaki
%A Masashi Inui
%A Tomokazu Shimizu
%A Toshihito Hirai
%A Yugo Sawada
%A Hideki Ishida
%A Kazunari Tanabe
%J Journal of Transplantation
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/546373
%X Objective. To assess the long-term graft survival of right-sided retroperitoneoscopic live donor nephrectomy (RPLDN), we compared the outcomes of right- and left-sided RPLDN. Methods. Five hundred and thirty-three patients underwent live donor renal transplantation with allografts procured by RPLDN from July 2001 to August 2010 at our institute. Of these, 24 (4.5%) cases were selected for right-sided RPLDN (R-RPLDN) according to our criteria for donor kidney selection. Study variables included peri- and postoperative clinical data. Results. No significant differences were found in the recipients' postoperative graft function and incidence of slow graft function. Despite significant increased warm ischemic time (WIT: mean 5.9£żmin versus 4.7£żmin, ) in R-RPLDN compared to that in L-RPLDN, there was no significant difference between the two groups regarding long-term patient and graft survival. The complication rate in R-RPLDN was not significantly different compared to that in L-RPLDN (17% versus 6.5%, ). No renal vein thrombosis was experienced in either groups. Conclusions. Although our study was retrospective and there was only a small number of R-RPLDN patients, R-RPLDN could be an option for laparoscopic live donor nephrectomy because of similar results, with the sole exception of WIT, in L-RPLDN, and its excellent long-term graft outcomes. 1. Introduction The first laparoscopic living-donor nephrectomy (LLDN) was performed by Ratner et al. [1]. Since then, there has been increased acceptance of the procedure in many countries. In Japan, the number of deceased donor kidneys available for transplantation has not shown any increase, but living donor kidney transplantation increases yearly [2]. Laparoscopic procurement can offer an advantage to living kidney donors. The recent outcome of laparoscopic donor nephrectomy seems to be greatly improved compared to that in the early years, but the procedure still remains challenging even for the most experienced laparoscopists [2¨C4]. This is apparent especially in contrast to open donor nephrectomy, in which the right kidney was removed in 24% to 35% of the patients. The rate of right-sided donor nephrectomy in various laparoscopic series ranges from 3.5% to 56.2% [5, 6]. According to the database from the United Network of Organ Sharing (UNOS), right LLDN represented only 10.5% of all LLDN in 2006 [7]. One reason for the reluctance to perform right-sided laparoscopic donor nephrectomy has been the high vascular complication rate and the technical difficulties reported in the initial series. Moreover,
%U http://www.hindawi.com/journals/jtrans/2013/546373/