Difficulties in Laparoscopic Live Donor Nephrectomy
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.Hoyert DL, Kung HC, Smith BL. Deaths: Preliminary data for 2003. Natl Health Stat Report. 2005;53(15):1-48. http://www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_15.pdf. Accessed on December 12, 2008.
- 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. http://www.usrds.org/atlas_2004.htm. Accessed December 30, 2008.
- 12.United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN). Donors recovered in the U.S. by donor type. http://www.optn.org/latestData. Accessed December 12, 2008.
- 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
- 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