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ORIGINAL ARTICLE
Year : 2009  |  Volume : 25  |  Issue : 2  |  Page : 195-198

Evaluating graft function in pediatric recipients for living donor renal transplantation: Is laparoscopic donor nephrectomy safe?


Department of Urology and Nephrology, Muljibhai Patel Society for Research in Nephrourology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India

Correspondence Address:
Mahesh R Desai
Department of Urology, Muljibhai Patel Urological Hospital, Nadiad-387 001, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.51358

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Objective: To evaluate the surgical and functional outcomes of laparoscopic graft procurement in pediatric patients undergoing renal transplantation. Materials and Methods: A retrospective chart review of the cohort records of 54 pediatric living donor renal transplant recipients from 1985 through June 2006 was performed. We compared results of laparoscopic donor nephrectomy (LDN, n = 15) and open donor nephrectomy (ODN, n = 39). Parameters analysed included donor technique and morbidity, operative complications, immediate postoperative renal function, the incidence of early and delayed graft function, and long-term graft survival. Results: The mean age of these recipients was 14.8 years (5-18) in the LDN group and 13.9 years (8-18) in ODN group. Serum creatinine (mg/dl) was 1.5 0.7 vs 1.8 1.3 at day 1 (P = 0.20), 1.0 0.3 vs 1.4 1.3 at day 2 (P = 0.12), 1.1 0.9 vs 1.3 1.0 at day 7 (P = 0.25), 1.2 0.5 vs 1.6 1.8 (P = 0.20) at day 14, 1.1 0.7 vs 1.2 1.4 (P = 0.39) at 1 month in LDN vs ODN groups, respectively. Early graft function was 35.7 vs 46.4% in the respective groups. There were two delayed graft function and one graft nonfunction in ODN group. Over all graft and patient survival at 1 year was 86.67 and 82.22% (P = 0.34) in LDN and ODN groups, respectively. Conclusion: Pediatric recipients of the LDN grafts have outcomes comparable to those of ODN graft recipients. Laparoscopic donor nephrectomy is safe and efficacious for graft procurement for pediatric recipients.


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