RESUMO
This study is to compare the short and long-term renal function between adult recipients of living laparoscopic and open donors [LR vs OR] to highlight the effect of the surgical technique on graft function. Moreover, we chose to compare the organic [hypertension, proteinuria, serum creatinine] and psychological [aspect of libido, need for anxiolytics] long-term effect of the surgery between laparoscopic and open donors [LD vs OD]
Methods: After census of adult recipients and living donors between 2003 and 2012, and after application of exclusion criteria and selection of homogeneous groups of donors and recipients, a retrospective cohort study was conducted between October 2008 and January 2012. In recipients, renal function in the short term was reported by the value of serum creatinine at +/- D5 post-op and the long-term values of serum creatinine at 6 and 12 months after surgery. Delayed graft function was defined by a serum creatinine value >/= 2.5 mg/dl on D5 post-op. A questionnaire for donors was established
Results: The two groups OR and LR were homogeneous concerning age, sex and body mass index [BMI]. Different groups OD and LD, chosen according to the variable of interest, were made homogeneous. Despite a different warm ischemia time between the 2 groups [175.54 seconds in LR vs 44.67 seconds in OR, p < 0.001], renal function in the short- and long-term in recipients was not statistically different [At day 5, 1.54 vs 1.50 mg/dl, p = 0.781; at 6 months, 1.37 vs 1.38, p = 0.871; at 12 months, 1.34 vs 1.36, p = 0.569, in OR and LR respectively]. Similarly, there was no significant statistical difference concerning organic and psychological complications between OD and LD except for a shorter period between hospital discharge and return to work in LD
Conclusion: In our center, renal function in the shortand long-term was similar in OR and LR. Apart from the advantages offered by the laparoscopic technique, organic and psychological long-term effects were similar between OD and LD. Nevertheless, laparoscopy seemed to facilitate kidney donation and is requested by almost all living donors independently of their social status