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

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.

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

Cross-over Kidney Transplantation with Simultaneous Laparoscopic Living Donor Nephrectomy: Initial Experience

2008 ◽  
Vol 53 (5) ◽  
pp. 1074-1078 ◽  
Author(s):  
Markus Giessing ◽  
Serdar Deger ◽  
Jan Roigas ◽  
Dietmar Schnorr ◽  
Florian Fuller ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Donor Nephrectomy ◽  
Initial Experience ◽  
Living Donor Nephrectomy

scholarly journals Kidney transplantation: A new era of laparoscopic living donor nephrectomy in Indonesia

2018 ◽  
Vol 41 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Albertus Marcelino ◽  
Chaidir Arif Mochtar ◽  
Irfan Wahyudi ◽  
Agus Rizal Hamid
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Donor Nephrectomy ◽  
New Era ◽  
Living Donor Nephrectomy

The economic impact of laparoscopic living-donor nephrectomy on kidney transplantation

2003 ◽  
Vol 75 (9) ◽  
pp. 1505-1512 ◽  
Author(s):  
C. Daniel Mullins ◽  
Simu K. Thomas ◽  
Fran??oise G. Pradel ◽  
Stephen T. Bartlett
Keyword(s):  
Kidney Transplantation ◽  
Economic Impact ◽  
Living Donor ◽  
Donor Nephrectomy ◽  
Living Donor Nephrectomy

Full Robot-Assisted Living Donor Nephrectomy and Kidney Transplantation in a Twin Dedicated Operating Room: Initial Experience From a High-Volume Robotic Center

2019 ◽  
Vol 26 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Giampaolo Siena ◽  
Graziano Vignolini ◽  
Andrea Mari ◽  
Vincenzo Li Marzi ◽  
Simone Caroassai ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Operating Room ◽  
Living Donor ◽  
High Volume ◽  
Late Complications ◽  
Donor Nephrectomy ◽  
Initial Experience ◽  
Robot Assisted ◽  
No Conversion ◽  
Living Donor Nephrectomy

Purpose. To describe our initial experience with a full robot-assisted approach for living donor nephrectomy (RALDN) and kidney transplantation (RAKT) in a dedicated twin operating room. Methods. From January to December 2017, 5 cases of RALDN and RAKT were performed in a single high-volume robotic center. All patients underwent a standard left RALDN. The renal hilum was controlled with Hem-O-Lok clips (WECK) and the kidney extracted through a Pfannenstiel incision. RAKT was performed according to the Vattikuti Urology Institute–Medanta technique. Results. RALDN: median estimated blood loss was 182 mL (range = 80-450 mL), no postoperative blood transfusion was required. The median (range) warm ischemia time was 175 (90-220 seconds). No conversion was registered. Median console time was 143 minutes (range = 115-220 minutes). No major surgical intraoperative and postoperative early and late complications occurred. RAKT: all 5 patients successfully underwent RAKT. Median (range) console time was 230 (190-200) minutes, vascular suture time was 58.7 (48-73) minutes, cold ischemia time was 46.2 (30-88) minutes, and rewarming time was 61.2 (55-72) minutes. No conversion was required. No major surgical intraoperative and postoperative early and late complications occurred. Mean glomerular filtration rate at days 1, 3, and 7 postoperatively was 26, 42, and 57 (range = 6-90) mL/min/1.73 m2, respectively. No case of delayed graft function was observed. No anastomosis revision, urological complications, lymphocele, and surgical site infection occurred. Conclusions. In our experience, RALDN and RAKT are safe and effective. The intuitiveness of the robotic approach provided substantial benefits both for the living donor and recipient from the very beginning of our series. No intraoperative and postoperative complications occurred.

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.

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