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Abstract
Laparoscopic living-donor nephrectomy (LLDN) has achieved a permanent place in renal
transplantation and in some centers has replaced open donor nephrectomy as the standard
technique.
To evaluate the published literature regarding the relative results and complications
of open LLDN and the hybrid technique of hand-assisted LLDN.
A systematic review of the literature was performed, searching PubMed and Web of Science.
A "free text" protocol using the term living-donor nephrectomy was applied. Six hundred
twenty-nine records were retrieved from the PubMed database and 686 records were retrieved
from the Web of Science database.
Fifty-seven comparative studies were identified in the literature search. The three
techniques of open, laparoscopic, and hand-assisted laparoscopic donor nephrectomy
were compared in terms of reported outcomes. With regard to the perioperative outcome
parameters, laparoscopy was better than open surgery in terms of blood loss, analgesic
requirements, and duration of hospital stay and convalescence. Postoperative graft
function was not significantly different between the different forms of donor nephrectomy,
although longer warm ischemia times are reported for laparoscopy.
All three techniques of live-donor nephrectomy are standard of care. The laparoscopic
techniques result in less postoperative pain and estimated blood loss with shorter
hospital stay, while postoperative graft function is not inferior to that after open
live-donor nephrectomy.
Copyright 2010 European Association of Urology. Published by Elsevier B.V. All rights
reserved.