Donor Lap Nephrectomy
In a laparoscopic donor nephrectomy, a kidney is transplanted from a living donor to a recipient, the patient. Traditionally, a live donor nephrectomy required a healthy individual, the donor, to undergo a major operation where the kidney was removed through an incision in the side using a large incision. This so-called "open" procedure was associated with significant pain and a substantial recuperation period for the donor.
In contrast, in a laparoscopic donor nephrectomy, tiny incisions are used and the kidney is removed using a scope or camera and special miniaturized surgical instruments. The procedure is, similar to one used to remove a gall bladder. This minimally invasive procedure has a shorter recovery period and the complication rate is very low. In addition, the quality and function of the transplanted kidneys are excellent.
In the procedure, the kidney is freed using 4 ports and removed through an incision in the lower abdomen.The transplant surgeon is waiting and immediately prepares the kidney and places it in the recipient. Results (graft survival) have been comparable to kidneys removed via traditional open surgery. In addition, patients are hospitalized approximately 3 days shorter and return to normal activity almost 3 weeks earlier.
Finally, when a patient receives a kidney from a living donor, as compared with a cadaver kidney from a deceased person, there are a number of distinct advantages including:
- decreased waiting time
- lower incidence of delayed graft function
- improved patient and graft survival
- increased cost effectiveness
Risks of Donor Lap Nephrectomy
The risks associated with donor nephrectomy those associated with the surgery itself, the remaining organ function and the psychological aspects involved with donating an organ.
For the kidney recipient, the risk of transplant surgery is usually low because it is a potentially lifesaving procedure. But kidney donation surgery can expose a healthy person to the risk of and recovery from unnecessary major surgery.
Immediate, surgery-related risks of donor nephrectomy include pain, infection, hernia, bleeding, blood clots, wound complications and, in rare cases, death.
Living-donor kidney transplant is the most widely studied type of living organ donation, with more than 50 years of follow-up information. Overall, studies show that life expectancy for those who have donated a kidney is the same as for similarly matched people who haven't donated.
Some studies suggest living kidney donors may have a slightly higher risk of kidney failure in the future. But this risk is still smaller than the average risk of kidney failure in the general population.
Specific long-term complications associated with living kidney donation include high blood pressure and elevated protein levels in urine (proteinuria).
Donating a kidney or any other organ may also cause mental health issues, such as symptoms of anxiety and depression. The donated kidney may fail in the recipient and cause feelings of regret, anger or resentment in the donor.
Overall, most living organ donors rate their experience as positive.
To minimize the potential risks associated with donor nephrectomy, you'll have extensive testing and evaluation to ensure you're eligible to donate.
Why it's done
Live kidney donation via a donor nephrectomy offers an alternative to waiting for a deceased-donor organ to become available for people in need of a kidney transplant.
A kidney transplant is usually the treatment of choice for kidney failure compared with a lifetime on dialysis.
The use of donor nephrectomy for live kidney donation has increased in recent years as the number of people waiting for a kidney transplant has increased dramatically. The demand for donor kidneys far outweighs the supply of deceased-donor kidneys, which makes living-donor kidney transplant an attractive option for people waiting for a deceased-donor kidney to become available.
In addition, living-donor kidney transplants are associated with several benefits for the recipient, including fewer complications and longer survival of the donor organ than in deceased-donor transplants.