الطرائق المختلفة لاستئصال الكلية من المتبرع الحي في مشافينا الجامعية

الملخص EN

Objective: The Living donor is still the sole source of renal graft in our country.

Like other surgical procedures, kidney procurement has its risks and complications which urge us to look for the best intervention that insures the donors safety and good graft quality.

This study was conducted to evaluate the outcome of different surgical techniques utilized in our centers in order to define the optimal one.

Methods: A prospective study was conducted in Almouassat and Alassad university hospitals including 297 renal donors from 2011 to 2014.

Patients were distributed according to the surgical nephrectomy technique into three categories: posterior lumber access, anterior extra-peritoneal access and handassisted laparoscopic.

The following data were collected to evaluate graft function: surgical time, warm ischemia time, hospitalization, convalescences, surgical complications and serum creatinine.

Results: Warm ischemia time was longer in the laparoscopic group than the open surgery groups (4.7 versus 1 min) which was statistically significant (P=0.01), but without clinical impact when following the serum creatinine six months post transplantation, (P=0.29).

Both the hospitalization and convalescence periods were shorter in the laparoscopic group, whereas the operation time was shorter in the posterior lumber group (90 versus 110 min medially).

Donor and recipient complications were similar and without statistical significance.

Conclusion: This study revealed that all the donor nephrectomy techniques applied in our centers were safe and free of serious donor complications and accompanied with good transplantation results.

It showed also a privilege of the hand-assisted laparoscopic nephrectomy concerning the cosmetic issues, the hospitalization and convalescence periods when compared to open procedures.

nevertheless, its elevated costs restrained its popularity.

However, the anterior abdominal extra peritoneal technique was a an adequate alternative with less post-surgical pain and convalescence period than the classic posterior lumber approach.

We look forward to employing the pure laparoscopic living donor nephrectomy in the future