Changes in Muscle Quality and Body Composition 1 Year After Hand-Assisted Laparoscopic Donor Nephrectomy in Living Kidney Donors

Background: Rhabdomyolysis is a post-operative complication resulting from skeletal muscle injury during the surgery. The true incidence of rhabdomyolysis in laparoscopic living donor nephrectomy is unknown due to a paucity of evidence in the literature. Rhabdomyolysis can have serious short-term and long-term consequences for the living kidney donors. There have been a number of risk factors identified that may increase the risk of rhabdomyolysis. Materials and Methods: Our program has offered a hand assisted laparoscopic donor nephrectomy approach for our donors since 2001.We have performed 209 kidney transplants using this approach. The institution’s database was searched for postoperative complications. Three donor patients with post-operative rhabdomyolysis were identified. Results: All three patients were young healthy males. The operative times were all greater than four hours. Fortunately, all three patients were recognized early and received treatment promptly. Dialysis was not required and no long-term renal dysfunction occurred. Conclusion: Rhabdomyolysis is an uncommon post-operative complication following hand assisted laparoscopic living donor nephrectomy. We have a high index of suspicion for rhabdomyolysis to promptly recognize this rare but potentially serious complication after any operation lasting greater than 4 hours. Creatinine Kinase levels have been implemented at our centre for all living kidney donors. Journal of Surgical Sciences (2015) Vol. 19 (2) : 44-47

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The Association between Body Composition Measurements and Surgical Complications after Living Kidney Donation

Journal of Clinical Medicine ◽

10.3390/jcm10010155 ◽

2021 ◽

Vol 10 (1) ◽

pp. 155

Author(s):

Lisa B. Westenberg ◽

Marco van Londen ◽

Camilo G. Sotomayor ◽

Cyril Moers ◽

Robert C. Minnee ◽

...

Keyword(s):

Body Composition ◽

Logistic Regression ◽

Postoperative Complications ◽

Surgical Complications ◽

Donor Nephrectomy ◽

Regression Analyses ◽

Kidney Donors ◽

Living Kidney Donors ◽

Binomial Logistic Regression ◽

Duration Of Surgery

Obesity is considered a risk factor for peri- and postoperative complications. Little is known about this risk in overweight living kidney donors. The aim of this study was to assess if anthropometric body measures and/or surgical determinants are associated with an increased incidence of peri- and postoperative complications after nephrectomy. We included 776 living kidney donors who donated between 2008 and 2018 at the University Medical Center Groningen. Prenephrectomy measures of body composition were body mass index (BMI), body surface area (BSA), waist circumference, weight, and waist–hip ratio. Incidence and severity of peri- and postoperative complications were assessed using the Comprehensive Complication Index. Mean donor age was 53 ± 11 years; 382 (49%) were male, and mean BMI at donor screening was 26.2 ± 3.41 kg/m2. In total, 77 donors (10%) experienced peri- and postoperative complications following donor nephrectomy. Male sex was significantly associated with fewer surgical complications (OR 0.59, 0.37–0.96 95%CI, p = 0.03) in binomial logistic regression analyses. Older age (OR: 1.03, 1.01–1.05 95%CI, p = 0.02) and a longer duration of surgery (OR: 1.01, 1.00–1.01 95%CI, p = 0.02) were significantly associated with more surgical complications in binomial logistic regression analyses. Multinomial logistic regression analyses did not identify any prenephrectomy measure of body composition associated with a higher risk of surgical complications. This study shows that higher prenephrectomy BMI and other anthropometric measures of body composition are not significantly associated with peri- and postoperative complications following living donor nephrectomy.

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