Difficulties in Laparoscopic Live Donor Nephrectomy

  • Jihad H. Kaouk
  • Wesley M. White


End stage renal disease (ESRD) is a leading cause of morbidity and death among Americans and represents a significant financial burden to the health care system of the United States. Traditionally, renal replacement therapy has come in the form of hemodialysis or renal transplantation. Certainly, the latter is associated with not only significantly better longevity but also a tangibly improved quality of life. Unfortunately, the pervasiveness of hypertensive and diabetic nephropathy in the Western culture has disproportionately exceeded the supply of available allografts. Within the context of this mounting shortage, the rate of deceased donor renal transplants has remained relatively stagnant. As a consequence, there exists a distinct and pressing need for increased accrual of living kidney donors. This chapter offers insight in the difficulties encountered during the procedure.


  1. 1.
    Hoyert DL, Kung HC, Smith BL. Deaths: Preliminary data for 2003. Natl Health Stat Report. 2005;53(15):1-48. Accessed on December 12, 2008.
  2. 2.
    Meier-Kriesche HU, Ojo AO, Port FK, Arndorfer JA, Cibrik DM, Kaplan B. Survival improvement among patients with end-stage renal disease: trends over time for transplant recipients and wait-listed patients. J Am Soc Nephrol. 2001;12:1293-1296.PubMedGoogle Scholar
  3. 3.
    Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341:1725-1730.CrossRefPubMedGoogle Scholar
  4. 4.
    National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases. U.S. Renal Data System 2004 annual data report: atlas of end-stage renal disease in the United States. Accessed December 30, 2008.
  5. 5.
    Sener A, Cooper M. Live donor nephrectomy for kidney transplantation. Nat Clin Pract Urol. 2008;5(4):203-210.CrossRefPubMedGoogle Scholar
  6. 6.
    Barry JM. Open donor nephrectomy: current status. BJU Int. 2005;95(Suppl 2):56-58.CrossRefPubMedGoogle Scholar
  7. 7.
    Streem SB, Novick AC, Steinmuller DR, Graneto D. Flank donor nephrectomy: efficacy in the donor and recipient. J Urol. 1989;141:1099-1101.CrossRefPubMedGoogle Scholar
  8. 8.
    Gill IS, Carbone JM, Clayman RV, et al. Laparoscopic live donor nephrectomy. J Endourol. 1994;8:143-148.CrossRefPubMedGoogle Scholar
  9. 9.
    Ratner LE, Ciseck LJ, Moore RG, Cigarroa FG, Kaufman HS, Kavoussi LR. Laparoscopic live donor nephrectomy. Transplantation. 1995;60:1047-1049.PubMedGoogle Scholar
  10. 10.
    Jacobs SC, Cho E, Foster C, Liao P, Bartlett ST. Laparoscopic live donor nephrectomy: the University of Maryland 6-year experience. J Urol. 2004;171:47-51.CrossRefPubMedGoogle Scholar
  11. 11.
    Sundaram CP, Martin GL, Guise A, et al. Complications after a 5-year experience with laparoscopic donor nephrectomy: the Indiana University experience. Surg Endosc. 2007;21:724-728.CrossRefPubMedGoogle Scholar
  12. 12.
    United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN). Donors recovered in the U.S. by donor type. Accessed December 12, 2008.
  13. 13.
    Simon SD, Castle EP, Ferrigni RG, et al. Complications of laparoscopic nephrectomy: the Mayo Clinic experience. J Urol. 2004;171:1447-1450.CrossRefPubMedGoogle Scholar
  14. 14.
    Bia MJ, Ramos EL, Danovich GM, et al. Evaluation of living renal donors: the current practice of U.S. transplant centers. Transplantation. 1995;60:322-326.CrossRefPubMedGoogle Scholar
  15. 15.
    Kasiske BL, Cangro CB, Hariharan S, et al. The evaluation of renal transplantation candidates: clinical practice guidelines. Am J Transplant. 2001;S2:1-95.Google Scholar
  16. 16.
    Kuo PC, Plotkin JS, Stevens S, Cribbs A, Johnson LB. Outcomes of laparoscopic donor nephrectomy in obese patients. Transplantation. 2000;69:180-181.CrossRefPubMedGoogle Scholar
  17. 17.
    Sundqvist P, Feuk U, Häggman M, Persson AEG, Stridsberg M, Wadström J. Hand-assisted retroperitoneoscopic live donor nephrectomy in comparison to open and laparoscopic procedures: a prospective study on donor morbidity and kidney function. Transplantation. 2004;78:147-153.CrossRefPubMedGoogle Scholar
  18. 18.
    Pozniak MA, Lee FT Jr. Computed tomographic angiography in the preoperative evaluation of potential renal transplant donors. Curr Opin Urol. 1999;9:165-170.CrossRefPubMedGoogle Scholar
  19. 19.
    Oh CK, Yoon SN, Lee BM, et al. Routine screening for the functional asymmetry of potential kidney donors. Transplant Proc. 2006;38:1971-1973.CrossRefPubMedGoogle Scholar
  20. 20.
    Posselt AM, Mahanty H, Kang S, et al. Laparoscopic right donor nephrectomy: a large single center experience. Transplantation. 2004;78:1665-1669.CrossRefPubMedGoogle Scholar
  21. 21.
    Turk IA, Giessing M, Deger S, et al. Laparoscopic live right donor nephrectomy: a new technique with preservation of vascular length. Transplant Proc. 2003;35:838-840.CrossRefPubMedGoogle Scholar
  22. 22.
    Tooher RL, Rao MM, Scott DF, et al. A systematic review of laparoscopic live-donor nephrectomy. Transplantation. 2004;78:404-414.CrossRefPubMedGoogle Scholar
  23. 23.
    Manikandan R, Sundaram CP. Laparoscopic live-donor nephrectomy. BJU Int. 2006;97:1154-1160.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Center for Laparoscopic and Robotic SurgeryClevelandUSA
  2. 2.Division of Urologic SurgeryThe University of Tennessee Medical CenterKnoxvilleUSA

Personalised recommendations