Comparison of hand-assisted laparoscopic and open donor nephrectomy in living donors

Objectives:   Although the advent of (hand-assisted) laparoscopic donor nephrectomy has had a positive effect on the donor pool, there is still some concern about the increased morbidity and safety of the laparoscopic donor nephrectomy. The aim of this study was to compare the results of hand-assisted laparoscopic donor nephrectomy (HALD) with open donor nephrectomy (ODN).
Methods:   A single-center non-randomized analysis of 202 living donor kidney transplantations (44 ODN, 158 HALD) between January 1995 and April 2006 was conducted.
Results:   The left kidney was harvested in 75% in the ODN group and 53% in the HALD group ( P  = 0.009). There was no conversion in the HALD group. Mean donor operative time for HALD (174 min) was longer than for ODN (124 min, P  < 0.001). The mean donor hospital stay (4.9 days vs 9.6 days, P  < 0.001) was significantly less for HALD. HALD had lower mean creatinine values at day 7 and 1 month ( P  = 0.001 and P  = 0.002) and lower urological complication rates ( P  = 0.02) compared with ODN. The 1-year graft survival rates of the ODN and the HALD group were 84% and 95% ( P  = 0.006), respectively.
Conclusion:   hand-assisted laparoscopic donor nephrectomy is a safe procedure for a donor nephrectomy with potential benefits compared with ODN.