Right nephrectomy vs left nephrectomy in living donor transplantation, analysis of evolution and prognosis. Report from a tertiary care hospital

Authors

  • Lorena Noriega-Salas Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.
  • José Cruz-Santiago Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.
  • Germán Bernáldez-Gómez Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.
  • Guillermo Meza-Jiménez Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.
  • Arlette Robledo-Meléndez Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.
  • Manuel Quiñones-Gamero Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.
  • Brenda Cano- Vargas Instituto Mexicano del Seguro Social, Hospital de Especialidades Médicas Centro Médico Nacional La Raza, Ciudad de México, México.

DOI:

https://doi.org/10.48193/revistamexicanadeurologa.v82i1.862

Keywords:

Donor, Kidney transplantation, Laparoscopic, Nephrectomy, Right

Abstract

Abstract

Kidney transplantation is the best renal replacement therapy for end-stage renal disease. Living donation constitutes the highest proportion of transplants in our country; donation nephrectomy requires assessment of renal function, which will influence the surgical planning of the kidney to donate.

Methods

We made a comparison between the evolutions of patients who underwent right nephrectomy versus left nephrectomy, for donation purposes in our center.

Results

Out of a total of 395 cases, 86 (21.7%) were right nephrectomies. With significant differences in the proportion of intraoperative complications, 2% for left nephrectomy and none for right nephrectomy; and more patients with postoperative complications (Clavien-Dindo II) for the left nephrectomy group, with a statistically significant difference (p = 0.02)

Discussion and Conclusions

Adequate surgical planning of the kidney to donate is required to ensure renal function after the donation event, as well as verification of the safety of the surgical act in the donor and the recipient, this must be collegiate and individualized for each transplant binomial.

 

References

Fernández C, Calvo M, Leite N, López A, Ferreiro T, Ribera R, et al. Kidney transplantation of 32 patients from HLA-incompatible live donors: Efficacy and outcome after desensitization. Nefrología (English Edition). 2017 Nov 1;37(6):638–45. doi: 10.1016/j.nefroe.2017.11.003

Centro Nacional de Transplantes. Reporte Anual 2019 de donación y transplantes en México. México: Secretiaria de Salud; 2020 p. 81.

Global Transplant Observatory on Donation and Transplantation. Summary Absolute and Rate Transplant and Donation per Million Habitants 2019. World Health Organization;

Musquera Felip M, Peri Cusí L, Alcaraz Asensio A. Surgical aspects of living-donor kidney transplantation]. Nefrologia. 2010;30(Suppl 2):71–9. doi: 10.3265/Nefrologia.pre2010.Nov.10693

Khalil A, Mujtaba MA, Taber TE, Yaqub MS, Goggins W, Powelson J, et al. Trends and outcomes in right vs. left living donor nephrectomy: an analysis of the OPTN/UNOS database of donor and recipient outcomes--should we be doing more right-sided nephrectomies? Clin Transplant. 2016;30(2):145–53. doi: 10.1111/ctr.12668

Gonzalez- Patiño E, Cuellar Bacrera H, Lopez Verdugo F, Becerra Espinoza JL, Estrada Bujanos JM. Experiencia en el Hospital Regional ISSSTE Monterrey, en nefrectomía laparoscópica de donante vivo para trasplante renal. Nefrol Mex. 2014;35(2).

Villca-Gonzales R. Evaluación de la función renal del donante: TFG, proteinuria, hematuria y urolitiasis. ¿Cómo evaluar? ¿Quién puede donar? Rev Mex Traspl. 2020;9(S1):22–9.

Wessells H, Deirmenjian J, McAninch JW. Preservation of renal function after reconstruction for trauma: quantitative assessment with radionuclide scintigraphy. J Urol. 1997;157(5):1583–6.

Yasuyuki K, Yukio U, Masanori S, Hoshi A, Hideshi M, Hiroyoshi I, et al. Evaluation of renal function after laparoscopic partial nephrectomy with renal scintigraphy using 99mtechnetium-mercaptoacetyltriglycine. International Journal of Urology. 2006;13(11):1371–4. doi: 10.1111/j.1442-2042.2006.01579.x

Weinberger S, Klarholz-Pevere C, Liefeldt L, Baeder M, Steckhan N, Friedersdorff F. Influence of CT-based depth correction of renal scintigraphy in evaluation of living kidney donors on side selection and postoperative renal function: is it necessary to know the relative renal function? World Journal of Urology. 2018;36(8):1327–32. doi: 10.1007/s00345-018-2272-0

Posselt AM, Mahanty H, Kang S-M, Stoller ML, Meng MV, Roberts JP, et al. Laparoscopic right donor nephrectomy: a large single-center experience. Transplantation. 2004;78(11):1665–9. doi: 10.1097/01.tp.0000144320.33956.42

Bollens R, Mikhaski D, Espinoza BP, Rosenblatt A, Hoang AD, Abramowicz D, et al. Laparoscopic live donor right nephrectomy: a new technique to maximize the length of the renal vein using a modified Endo GIA stapler. Eur Urol. 2007;51(5):1326–31. doi: 10.1016/j.eururo.2006.11.052

Choi SW, Kim KS, Kim S, Choi YS, Bae WJ, Hong S-H, et al. Hand-assisted and pure laparoscopic living donor nephrectomy: a matched-cohort comparison over 10 yr at a single institute. Clin Transplant. 2014;28(11):1287–93. doi: 10.1111/ctr.12462

Boentoro S, Wahyudi I, Mochtar CA, Hamid ARA. Blood Transfusions in Laparoscopic Living Donor Nephrectomy: Single Center Experience from 500 Cases. Res Rep Urol. 2020;12:1–5. doi: 10.2147/RRU.S229431

Grochowiecki T, Madej K, Gałązka Z, Jakimowicz T, Jędrasik M, Świercz P, et al. Usefulness of Modified Dindo-Clavien Scale to Evaluate the Correlation Between the Severity of Surgical Complications and Complications Related to the Renal and Pancreatic Grafts After Simultaneous Kidney and Pancreas Transplantation. Transplant Proc. 2016;48(5):1677–80. doi: 10.1016/j.transproceed.2016.01.091

Published

2022-02-21 — Updated on 2022-02-22

Versions

Issue

Section

Original articles