Journal ArticleDOI
A comparison of recipient renal outcomes with laparoscopic versus open live donor nephrectomy.
J Nogueira,Charles B. Cangro,Jeffrey C. Fink,Eugene J. Schweitzer,Ann Wiland,David K. Klassen,James F. Gardner,John L. Flowers,Stephen C. Jacobs,Eugene Cho,Benjamin Philosophe,Stephen T. Bartlett,Matthew R. Weir +12 more
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TLDR
Although laparoNx allografts have slower initial function compared with openNx, there was no significant difference in longer term renal function.Abstract:Â
Background. Laparoscopic donor nephrectomy (laparoNx) has the potential to increase living kidney donation rates by reducing the pain and suffering of the donor. However, renal function outcomes of a large series of recipients of laparoNx have not been studied. Methods. We retrospectively reviewed the records of 132 recipients of laparoNx done at our center between 3/96 and 11/97 and compared them to 99 recipients of kidneys procured by the open technique (openNx) done between 10/93 and 3/96. Results. Significantly more patients in the laparoNx group (25.2%) were taking tacrolimus within the first month than those in the openNx group (2.1%). Mean serum creatinine was higher in laparoNx compared with openNx at 1 week (2.860.3 and 1.860.2 mg/dl, respectively; P50.005) and at 1 month (2.060.1 and 1.660.1 mg/dl, P50.05) after transplant. However, by 3 and 6 months, the mean serum creatinine was similar in the two groups (1.760.1 versus 1.560.05 mg/dl, and 1.760.1 versus 1.760.1, respectively). By 1 year posttransplant, the mean serum creatinine for laparoNx was actually less than that for openNx (1.460.1 and 1.760.1 mg/dl, P50.03). Although patients in the laparoNx compared to the openNx group were more likely to have delayed graft function (7.6 versus 2.0%) and ureteral complications (4.5 versus 1.0%), the rate of other complications, as well as hospital length of stay, patient and graft survival rates were similar in the two groups. Conclusion. Although laparoNx allografts have slower initial function compared with openNx, there was no significant difference in longer term renal function. Kidney transplantation is considered to be the treatment of choice for end-stage renal failure. Insufficient supply of organs for donation has produced long waiting times for many patients who may benefit from transplantation (1). During this period patients accumulate the morbidity of renal failure, they must endure the lifestyle limitations of dialysis, and they often die while waiting for the organ sharing system to grant them this resource. Live donor renal transplantation represents a large potential supply of organs that may relieve much of this shortage. Additionally, recipients of live renal transplants may reap benefits of improved patient and allograft survival that have been clearly demonstrated in this population (2,3). Although unilateral nephrectomy has proven to be safe and the solitary kidney state has been found to be well tolerated in a carefully chosen candidate for donation (4,5), substantial disincentives to donation exist. These include a significant hospitalization, prolonged convalescence period with time away from jobs, intractable perioperative pain, and, for some, cosmetic concerns of the resultingread more
Citations
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Journal ArticleDOI
Laparoscopic live donor nephrectomy
TL;DR: In this paper, the authors describe the technique of laparoscopic live donor nephrectomy and briefly report the results, which resulted in improved postoperative recovery and shorter convalescence, with no effect on recipient renal function.
Journal ArticleDOI
Increased rates of donation with laparoscopic donor nephrectomy.
Eugene J. Schweitzer,J. Wilson,Stephen C. Jacobs,Carol H. Machan,Benjamin Philosophe,Alan C. Farney,John O. Colonna,Bruce Jarrell,Stephen T. Bartlett +8 more
TL;DR: The availability of LDN and an LD family education program has doubled the live donor transplantation rate, and outcomes remain excellent.
Journal ArticleDOI
Laparoscopic radical nephrectomy: cancer control for renal cell carcinoma
TL;DR: Laroscopic radical nephrectomy is an effective alternative for localized renal cell carcinoma when the principles of surgical oncology are maintained and initial data show shorter patient hospitalization and effective cancer control with no significant difference in survival compared with open radical ne phrectomy.
Journal ArticleDOI
Laparoscopic versus open live donor nephrectomy in renal transplantation: a meta-analysis
Theodore G. Nanidis,David Antcliffe,Constantinos Kokkinos,Catherine A. Borysiewicz,Ara Darzi,Paris P. Tekkis,Vassilios Papalois +6 more
TL;DR: Although open neph rectomy may be associated with shorter operative and warm ischemia times, patients undergoing laparoscopic nephrectomy may benefit from a shorter hospital stay and faster return to work without compromising graft function.
Journal ArticleDOI
Nutcracker Syndrome: An Update on Current Diagnostic Criteria and Management Guidelines.
TL;DR: The evidence basis for conservative, medical and surgical options in the management of Nutcracker syndrome is explored and three main pathways exist: open surgery, laparoscopic surgery and endovascular approaches.
References
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Journal ArticleDOI
International standardization of criteria for the histologic diagnosis of renal allograft rejection : the Banff working classification of kidney transplant pathology
Kim Solez,Roy A. Axelsen,Hallgrimur Benediktsson,James F. Burdick,Arthur H. Cohen,Robert B. Colvin,Byron P. Croker,Dominique Droz,Michael S. Dunnill,Philip F. Halloran,Pekka Häyry,J. Charles Jennette,Paul Keown,Niels Marcussen,Michael J. Mihatsch,Kunio Morozumi,Bryan D. Myers,Cynthia C. Nast,Steen Olsen,Lorraine C. Racusen,E L Ramos,Seymour Rosen,David H. Sachs,Daniel R. Salomon,Fred Sanfilippo,Regina R. Verani,Eeva von Willebrand,Yutaka Yamaguchi +27 more
TL;DR: A schema for international standardization of nomenclature and criteria for the histologic diagnosis of renal allograft rejection was developed in Banff, Canada on August 2-4, 1991 and validated by the circulation of sets of slides for scoring by participant pathologists.
Journal Article
Laparoscopic live donor nephrectomy
Lloyd E. Ratner,L. J. Ciseck,Robert G. Moore,Francisco G. Cigarroa,Howard S. Kaufman,Louis R. Kavoussi +5 more
TL;DR: The technique of laparoscopic live donor nephrectomy has resulted in improved postoperative recovery and shorter convalescence, with no effect on recipient renal function.
Journal ArticleDOI
20 years or more of follow-up of living kidney donors.
TL;DR: It is concluded that perioperative mortality in the USA and Canada after living-donor nephrectomy is low and in long-term follow-up of living donors, there is no evidence of progressive renal deterioration or other serious disorders.
Journal Article
The UNOS Scientific Renal Transplant Registry.
Cecka Jm,Paul I. Terasaki +1 more
TL;DR: Based upon data reported to the UNOS Scientific Renal Transplant Registry regarding transplants performed between 1994-1998, the one- and 3-year graft survival rates for 16,288 recipients of living donor kidneys were 93% and 86%, respectively, with a half-life of 17 years.
Journal ArticleDOI
Delayed graft function, acute rejection, and outcome after cadaver renal transplantation: A multivariate analysis
Christoph Troppmann,K. J. Gillingham,Enrico Benedetti,P. S. Almond,Rainer W.G. Gruessner,J. S. Najarian,Arthur J. Matas +6 more
TL;DR: The impact of delayed graft function on outcome after cadaver renal transplantation has been controversial, but most authors fail to control for the presence or absence of rejection.