Perioperative outcomes of laparoscopic donor nephrectomy: A single-center experience

Introduction: Laparoscopic donor nephrectomy (LDN) remains the gold standard for living kidney donation. There is controversy over the optimal method for controlling the renal vessels. In this study, we assessed the outcomes of LDN and compared postoperative outcomes based on donor demographics and method of vascular control. Materials and Methods: We conducted a retrospective single-center review examining all adult patients who underwent LDN from 2017 to 2022. The outcomes collected included transfusion rate, estimated blood loss (EBL), reintervention rate, and overall 30-day complication rate. We also analyzed intra- and postoperative variables, including operative duration, conversion to open, method of vascular control, change in renal function, and length of stay. Results: 168 patients were included, with the majority (81%) of patients undergoing left LDN. The median EBL was 100 mL (interquartile range 100–200 mL). Only two patients (1%) experienced hemorrhagic complications, though none was a result of clip or staple malfunction. The most common methods of arterial control were staples and clips (69%) and clips alone (28%), and the use of staples and clips was associated with longer operative duration. However, there were no significant differences in EBL, length of stay, or complication rate between groups. No patients required surgical reintervention for any reason, and there were no postoperative deaths. Conclusion: At our center, LDN was associated with low rates of hemorrhagic complications. There was no association between the method used to control the renal artery and perioperative outcomes or complication rates. Our data suggest that LDN is a safe procedure with low complication rates.