scholarly journals Lower rate of delayed graft function is observed when epidural analgesia for living donor nephrectomy is administered

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wolfgang Baar ◽  
Ulrich Goebel ◽  
Hartmut Buerkle ◽  
Bernd Jaenigen ◽  
Kai Kaufmann ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Living Donor ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Delayed Graft Function ◽  
Living Donor Nephrectomy

scholarly journals Lower rate of delayed graft function is observed when epidural analgesia for living donor nephrectomy is administered.

2019 ◽  
Author(s):  
Wolfgang Baar ◽  
Ulrich Goebel ◽  
Hartmut Buerkle ◽  
Bernd Jaenigen ◽  
Kai Kaufmann ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Living Donor ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Delayed Graft Function ◽  
Donor Kidney ◽  
Kidney Donors ◽  
Living Donor Nephrectomy ◽  
Kidney Transplantations ◽  
Living Donor Kidney

Abstract Background The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for living donor nephrectomy has effects on postoperative graft function in recipients. Methods In this monocentric, retrospective cohort analysis we analyzed the closed files of all consecutive donor- recipient pairs who underwent living donor kidney transplantations from 2008 to 2017. The outcome variable was delayed graft function (DGF), defined as at least one hemodialysis within seven days postoperatively, once hyperacute rejection, vascular or urinary tract complications were ruled out. Statistical analyses of continuous variables were calculated using the two-tail Student’s t test and Fisher exact test for categorical variables with a significance level of p<0.05, respectively. Results The study enclosed 291 consecutive living donor kidney transplantations. 99 kidney donors received epidural analgesia whereas 192 had no epidural analgesia. The groups showed balanced pretransplantational characteristics and comparable donors´ and recipients’ risk factors. 9 out of all 291 recipients needed renal replacement therapy (RRT) during the first 7 days due to delayed graft function; none of these donors received EDA. The observed rate of DGF in recipients whose kidney donors received epidural analgesia was significantly lower (0% vs. 4.6%; p=0.031). Conclusions In our cohort we observed a significantly lower rate of DGF when epidural analgesia for donor nephrectomy was administered. Due to restrictions of the study design this observation needs further confirmation by prospective studies.

scholarly journals Lower rate of delayed graft function is observed when epidural analgesia for living donor nephrectomy is administered

2019 ◽  
Author(s):  
Wolfgang Baar ◽  
Ulrich Goebel ◽  
Hartmut Buerkle ◽  
Bernd Jaenigen ◽  
Kai Kaufmann ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Living Donor ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Delayed Graft Function ◽  
Donor Kidney ◽  
Kidney Donors ◽  
Living Donor Nephrectomy ◽  
Kidney Transplantations ◽  
Living Donor Kidney

Abstract Background The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for living donor nephrectomy has effects on postoperative graft function in recipients. Methods In this monocentric, retrospective cohort analysis we analyzed the closed files of all consecutive donor- recipient pairs who underwent living donor kidney transplantations from 2008 to 2017. The outcome variable was delayed graft function (DGF), defined as at least one hemodialysis within seven days postoperatively, once hyperacute rejection, vascular or urinary tract complications were ruled out. Statistical analyses of continuous variables were calculated using the two-tail Student’s t test and Fisher exact test for categorical variables with a significance level of p<0.05, respectively. Results The study enclosed 291 consecutive living donor kidney transplantations. 99 kidney donors received epidural analgesia whereas 192 had no epidural analgesia. The groups showed balanced pretransplantational characteristics and comparable donors´ and recipients’ risk factors. 9 out of all 291 recipients needed renal replacement therapy (RRT) during the first 7 days due to delayed graft function; none of these donors received EDA. The observed rate of DGF in recipients whose kidney donors received epidural analgesia was significantly lower (0% vs. 4.6%; p=0.031). Conclusions In our cohort we observed a significantly lower rate of DGF when epidural analgesia for donor nephrectomy was administered. Due to restrictions of the study design this observation needs further confirmation by prospective studies.

scholarly journals Epidural analgesia for living donor nephrectomy is associated with better early graft function in recipients after transplantation

2018 ◽  
Author(s):  
Wolfgang Baar ◽  
Ulrich Goebel ◽  
Hartmut Buerkle ◽  
Bernd Jaenigen ◽  
Kai Kaufmann ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Living Donor ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Delayed Graft Function ◽  
Donor Kidney ◽  
Kidney Donors ◽  
Living Donor Nephrectomy ◽  
Kidney Transplantations ◽  
Living Donor Kidney

Abstract Background: The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for living donor nephrectomy has effects on postoperative graft function in recipients. Methods: In this monocentric, retrospective cohort analysis we analyzed the closed files of all consecutive donor- recipient pairs who underwent living donor kidney transplantations from 2008 to 2017. The outcome variable was delayed graft function (DGF), defined as at least one hemodialysis within seven days postoperatively, once hyperacute rejection, vascular or urinary tract complications were ruled out. Statistical analyses of continuous variables were calculated using the two-tail Student’s t test and Fisher exact test for categorical variables with a significance level of p<0.05, respectively. Results: The study enclosed 291 consecutive living donor kidney transplantations. 99 kidney donors received epidural analgesia whereas 192 denied epidural analgesia. The groups showed balanced pretransplantational characteristics and comparable donors´ and recipients’ risk factors. 9 out of all 291 recipients needed renal replacement therapy (RRT) during the first 7 days due to delayed graft function; all of these donors received no EDA. The observed rate of DGF in recipients whose kidney donors received epidural analgesia was significantly lower (0% vs. 4.6%; p<0.031). Conclusions: In our cohort we observed a significantly lower rate of DGF when epidural analgesia for donor nephrectomy was administered. Du to restrictions of the study design this observation needs further confirmation by prospective studies. Key words: Kidney transplantation, delayed graft function, epidural analgesia, donor nephrectomy

scholarly journals Right Kidney Mini-Invasive Living Donor Nephrectomy: A Safe and Efficient Alternative

2020 ◽  
Vol 104 (11-12) ◽  
pp. 859-864
Author(s):  
Lucas Broudeur ◽  
Georges Karam ◽  
Reshma Rana Magar ◽  
Pascal Glemain ◽  
Thomas Loubersac ◽  
...  
Keyword(s):  
Living Donor ◽  
Left Kidney ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Safe Procedure ◽  
Conversion To Open Surgery ◽  
Living Donor Nephrectomy ◽  
Donor Safety ◽  
Living Donor Transplantation ◽  
Significant Difference

<b><i>Introduction:</i></b> Right kidney living donor transplantation is considered more difficult and associated with more complications. The objective was to evaluate donor safety and graft function of right hand-assisted laparoscopic donor nephrectomy (HALDN). <b><i>Methods:</i></b> A total of 270 consecutive HALDN procedures have been performed in our institution up to April 2017. We retrospectively compared the outcomes of right-sided nephrectomy (R-HALDN) to left-sided nephrectomy (L-HALDN) to evaluate donor safety and graft function of R-HALDN. <b><i>Results:</i></b> Sixty-seven right kidneys were removed for functional asymmetry in favour of left kidney (35/67) or left kidney multiple arteries (28/67). Among the donors, neither conversion to open surgery nor preoperative blood transfusion was necessary. There was no significant difference in operative time, compared to L-HALDN group (170 ± 37 min vs. 171 ± 32 min; <i>p</i> value = 0.182). Warm ischaemia time was significantly longer for R-HALDN (4.0 ± 1.6 min vs. 3.0 ± 1.7 min; <i>p</i> &#x3c; 0.001). There was no significant difference in terms of post-operative complications and serum Cr levels. Among the recipients, there were no graft venous thrombosis. There was no significant difference in delayed graft function (3 for R-HALDN group and 8 for L-HALDN group; <i>p</i> value = 0.847), serum Cr levels, and graft survival. <b><i>Conclusion:</i></b> R-HALDN is a safe procedure for kidney donors, with excellent graft function for the recipients, compared to L-HALDN.

Single-Center Analysis of Living Donor Nephrectomy: Hand-Assisted Laparoscopic, Pure Laparoscopic, and Traditional Open

2002 ◽  
Vol 12 (3) ◽  
pp. 208-211 ◽  
Author(s):  
Douglas P. Slakey ◽  
Julie Cauvin Hahn ◽  
Ethan Rogers ◽  
Philippe M. Gauthier ◽  
Gilberto Ruiz-Deya ◽  
...  
Keyword(s):  
Kidney Function ◽  
Living Donor ◽  
Graft Function ◽  
Laparoscopic Group ◽  
Donor Nephrectomy ◽  
Laparoscopic Technique ◽  
Complication Rates ◽  
Living Donor Nephrectomy

Context Laparoscopic living donor nephrectomy has been shown to be a safe method for removing kidneys for transplantation, but concerns have been raised regarding safety and long-term kidney function. Objective To compare safety and long-term kidney function in hand-assisted laparoscopic, pure laparoscopic, and traditional open living donor nephrectomy. Method The charts of 48 patients with more than 1 year follow-up were reviewed. Thirty-four consecutive patients underwent laparoscopic live donor nephrectomy, and 14 had open donor nephrectomy. All kidneys functioned immediately at transplantation. In the laparoscopic group, 11 had the pure laparoscopic technique, and 23 patients had hand-assisted laparoscopic nephrectomy. Results Total operative and warm ischemic times were reduced with the hand-assisted technique when compared with pure laparoscopy. Operative and warm ischemic times were similar in open nephrectomy and hand-assisted laparoscopy. Long-term follow-up of serum creatinine levels revealed no significant differences between the 3 groups. Complication rates in the 3 groups were similar. Conclusion Laparoscopic donor nephrectomy appears to be comparable to open donor nephrectomy in terms of safety and long-term graft function.

Surgical Aspects of Kidney Transplantation

2017 ◽  
Author(s):  
Anupamaa Seshadri ◽  
Sayeed Malek
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Living Donor ◽  
Transplant Patient ◽  
Graft Function ◽  
Donor Nephrectomy ◽  
Kidney Transplant Patient ◽  
Living Donor Nephrectomy ◽  
Living Donor Transplantation ◽  
Surgical Aspects

Kidney transplantation is the treatment of choice for patients with end-stage renal disease. This review discusses the surgical aspects of kidney transplantation in detail, beginning with the important features of the preoperative evaluation of a potential transplant recipient. We then explain in detail the technical aspects of living donor nephrectomy and kidney transplantation and provide guidance for managing variability in donor organ anatomy. Immediate postoperative management of the kidney transplant patient is briefly discussed. Finally, this review addresses the important postoperative complications to be aware of in the kidney transplant patient and management strategies, as well as outcomes of kidney transplantation. Key words: chronic kidney disease, deceased donor transplantation, delayed graft function, kidney transplant, living donor nephrectomy, living donor transplantation, lymphocele, renal artery stenosis, transplant workup, urologic complications

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