ABSTRACT
INTRODUCTION: The live donor nephrectomy is an unusual surgical procedure as it is performed on healthy individuals. It is important to make the procedure as safe as possible without compromising the health of the donor and graft function. JUSTIFICATION: In Mexico during 2014, 2610 kidney transplantations performed, and 1862 grafts were from living donors. OBJECTIVE: We describe our experience with hand-assisted laparoscopic nephrectomy on live donors for kidney transplantation. MATERIALS AND METHODS: We present a descriptive and observational study in which all living donors who completed the study protocol for renal transplantation are included. RESULTS: From September 2006 to July 2015, there were 238 hand-assisted laparoscopic nephrectomies with live donors; 227 (95.37%) were performed on the left side and 11 (4.63%) on the right side. Of donors, 54.1% were females. The average values for the variables analyzed were age 38.17 years, 25.94 BMI, creatinine 0.82-1.13 mg/dL pre- and postoperative month respectively, length of stay 4.95 (range 2-8), warm ischemia 5.07 (range 3-13) minutes, surgical time 168.85 minutes (range 90-306), and transsurgical bleeding 139 055 mL (range 25-650). One patient was reoperated for abdominal pain and bloating without evidence of pathology, attributing it to metabolic ileus. Two patients were converted to open surgery; 1 by technical problems with the laparoscopic equipment and the second by bleeding from the renal vein, both with good results. DISCUSSION AND CONCLUSIONS: Laparoscopic nephrectomy is a safe method that allows kidney donors to have a speedy recovery without modifying the survivals of renal grafts.
Subject(s)
Hand-Assisted Laparoscopy/methods , Kidney Transplantation/methods , Living Donors , Nephrectomy/methods , Tissue and Organ Harvesting/methods , Adult , Aged , Female , Humans , Laparoscopy/methods , Male , Mexico , Middle Aged , Operative TimeSubject(s)
Graft Survival , Kidney Transplantation , Actuarial Analysis , Follow-Up Studies , Histocompatibility Testing , Humans , Immunosuppression Therapy/methods , Kidney Transplantation/mortality , Kidney Transplantation/physiology , Mexico , Postoperative Complications/epidemiology , Postoperative Complications/mortality , Retrospective Studies , Survival Analysis , Transplantation, HomologousSubject(s)
Blood Transfusion , Cyclosporins/therapeutic use , Graft Survival , Kidney Transplantation/immunology , Adult , Family , Female , Haplotypes , Humans , Male , Risk Factors , Tissue Donors , Transplantation, HomologousSubject(s)
Kidney Transplantation , Kidney/physiology , Nephrectomy , Tissue Donors , Adult , Blood Pressure , Follow-Up Studies , Humans , Hypertrophy , Kidney/anatomy & histology , Kidney/pathology , Mexico , Middle AgedABSTRACT
Ectopic intrathoracic kidney is an extremely rare congenital disorder. It is generally asymptomatic, being discovered as incidental finding on a routine chest radiograph. Diagnosis is established by an intravenous pyelogram demonstrating an abnormally shaped excretory system with longer than usual ureters, which also helps to differentiate it from other posterior mediastinal tumors, such as neurogenic masses, including neuroblastoma, ganglioneuroma, neurofibroma, neuroenteric cysts, meningoceles and hernia of the foramen of Bochdalek.
