scholarly journals LAPAROSCOPIC LIVING DONOR NEPHRECTOMY: FEASIBILITY AND FIRST EXPERIENCE IN INDONESIA

2012 ◽  
Vol 19 (2) ◽  
Author(s):  
Chaidir A. Mochtar ◽  
Irfan Wahyudi ◽  
Nur Rasyid ◽  
Arry Rodjani ◽  
Ponco Birowo ◽  
...  
Keyword(s):  
Living Donor ◽  
Left Kidney ◽  
Hypertensive Heart Disease ◽  
Oral Intake ◽  
Operation Time ◽  
Donor Nephrectomy ◽  
Living Donor Nephrectomy ◽  
Estimated Blood Loss ◽  
Living Donor Transplantation ◽  
Stage Renal Disease

Objective: To report our first experience laparoscopic living donor nephrectomy (LLDN). Material & Method: A 37 year-old man was planned for the living-donor transplantation. The recipient was a 63 year-old man sufferingfrom end stage renal disease, and hypertensive heart disease. The donor and recipient were allowed for positive qualification evaluated preoperatively. We applied a transperitoneal approach for the left kidney. Results: The operation time was 300 minutes and the estimated blood loss was 600 mL. The first warm ischemia time was 15 minutes and 24 seconds. There were no major intraoperative and postoperative complications. The donor began oral intake and mobilization within 10 hours and was hospitalized for 4 days. The recipient’s serum creatinine levels reached near baseline levels (1,5 mg/dL) at day 6. Conclusion: LLDN is technically feasible in Indonesia and may increase the rate of kidney donation in Indonesia due to the minimally invasive nature of the procedure.Keywords: Renal transplantation, laparoscopic living donor nephrectomy, Indonesia.

scholarly journals LAPAROSCOPIC LIVING DONOR NEPHRECTOMY IN INDONESIA

2014 ◽  
Vol 21 (2) ◽  
Author(s):  
Chaidir Arif Mochtar ◽  
Irfan Wahyudi ◽  
Bagus Baskoro
Keyword(s):  
Blood Loss ◽  
Return To Work ◽  
Hospital Stay ◽  
Living Donor ◽  
Left Kidney ◽  
Donor Nephrectomy ◽  
Female Ratio ◽  
Living Donor Nephrectomy ◽  
Post Surgery ◽  
Estimated Blood Loss

Objective: To evaluate and analyze variables related to the surgical and direct post-operative outcomes of our initial experience of laparoscopic living donor nephrectomies (LLDN). Material & methods: This retrospective analysis describes the first 10 laparoscopic nephrectomies in living donors performed in Cipto Mangunkusumo Hospital. All surgeries were performed by the same surgical team. Variables related to the surgical and post-operative outcome and complications in donors were evaluated and analyzed.Results: The average age of the donors was 31.8 years with male : female ratio of 7 : 3. Thirty percent of them were family related to the recipient. The left kidney was extracted from all patients and multiple renal vessels were found in one cases. The mean operation time was 321.9 ± 27 min, first warm ischemia time was 9.37 ± 3.34 min and estimated blood loss was 270 ± 182.87ml. The hospital stay was 4.1 ± 1.3 days, VAS in the first day post surgery was 3 ± 1 with epidural analgesia needed for 1.8 ± 0.6 days, and drain was kept in for 2.8 ± 1.2 days while urethral cathether for 2.4 ± 1.2. Time to return to work was 16 ± 8.4 days. Conclusion: LLDN results in acceptable blood loss,less post-operative pain, short hospital stay and short time to return to work for the donors, therefore promising to be the gold standard among living donor nephrectomy surgical options.Keywords: Laparoscopic living donor nephrectomy,renal transplantation, Indonesia.

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.

Safety of Polymer Clips in Laparoscopic Living Donor Nephrectomy: Indonesian Experience

2018 ◽  
Vol 24 (8) ◽  
pp. 6238-6241
Author(s):  
Karina Evelyn Sidabutar ◽  
A. R Hamid ◽  
Nur Rasyid ◽  
Arry Rodjani ◽  
Irfan Wahyudi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Renal Artery ◽  
Renal Vein ◽  
Living Donor ◽  
Donor Nephrectomy ◽  
Vascular Control ◽  
Ischemic Time ◽  
Warm Ischemic Time ◽  
Living Donor Nephrectomy ◽  
Estimated Blood Loss

To assess the reliability and safety of polymer clips for vascular control in laparoscopic living donor nephrectomy. We collected data retrospectively from all laparoscopic living donor nephrectomy performed in Ciptomangunkusumo Hospital, Jakarta, Indonesia. Polymer clips was applied for both renal artery and renal vein ligation. The incidence of polymer clip failure was recorded accordingly. Between November 2011 and August 2015, we evaluated 260 patients of laparoscopic living donor nephrectomy in a center. The left kidney was harvested from 219 (84.5%) patients. Multiple renal arteries was discovered in 25 (9.6%) patients. For all cases we used polymer clips to control the renal artery (XL and L) and renal vein (XL). We placed 2 clips as proximal as possible to the aorta or caval vein. The median estimated blood loss was 100 (20–2000) ml. A blood loss of 2000 ml occurred in one/case of clip dislodgement. The median time to clip (the length of time from first incision to renal artery clamping) was 155 (68–318) minutes. The median warm ischemic time (the length of time from clamping to cold ischemic time) was 3.01 (1.22–30.43) minutes. There were 10 cases with warm ischemic time of more than 10 minutes. Three cases (1.2%) of clip failures occurred. One patient needed conversion to open surgery to achieve adequate vascular control. Two patients experienced improper locking of the polymer clips, necessitating clips reapplication. The use of polymer clips for vascular control in laparoscopic living donor nephrectomy is reliable and safe when properly applied. However the evaluation of renal vascular stump after harvesting donor kidney is an important step to ensure the right placement and safety of polymer clips.

Patients' attitudes about living donor transplantation and living donor nephrectomy

2003 ◽  
Vol 41 (4) ◽  
pp. 849-858 ◽  
Author(s):  
Françoise G Pradel ◽  
M.Rhona Limcangco ◽  
C.Daniel Mullins ◽  
Stephen T Bartlett
Keyword(s):  
Living Donor ◽  
Donor Nephrectomy ◽  
Living Donor Nephrectomy ◽  
Living Donor Transplantation

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 Laparoscopic Living-Donor Nephrectomy of a Horseshoe Kidney: A Case Report and Review of the Literature

2021 ◽  
Vol 2 (4) ◽  
pp. 455-459
Author(s):  
Daniel Galvez ◽  
Justin Steggerda ◽  
Derrick Christopher ◽  
Daniel Borja-Cacho ◽  
Joseph Leventhal
Keyword(s):  
Living Donor ◽  
Iliac Fossa ◽  
Horseshoe Kidney ◽  
Donor Nephrectomy ◽  
Cross Sectional ◽  
Living Donor Nephrectomy ◽  
Fibrotic Band ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

We present the case of a living-donor nephrectomy of a horseshoe kidney. The recipient was a 33-year-old male with a history of end-stage renal disease secondary to IgA nephropathy. The donor was his 33-year-old partner who on preoperative cross-sectional imaging was found to have a horseshoe kidney with a single artery, vein and ureter. The donor operation was performed using a laparoscopic hand-assisted technique with transection of the interpolar fibrotic band using a stapler device. The backtable organ preparation was performed in a standard fashion with addition of a reinforcing hemostatic suture of the stapled fibrotic band. The donated kidney was transplanted extraperitoneally in the right iliac fossa of the recipient. The patient had an unremarkable postoperative course and was discharged home on post operative day 2 with normalizing renal function. To our knowledge, this is the first living donor nephrectomy of a horseshoe kidney performed using a laparoscopic hand-assisted technique.

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