Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy

Matteo Ravaioli, Enzo Capocasale, Lucrezia Furian, Vanessa De Pace, Maurizio Iaria, Gionata Spagnoletti, Maria Paola Salerno, Alessandro Giacomoni, Luciano De Carlis, Caterina Di Bella, Nguefouet Momo Rostand, Luigino Boschiero, Giovanni Pasquale, Andrea Bosio, Andrea Collini, Mario Carmellini, Andrea Airoldi, Gianmarco Bondonno, Pasquale Ditonno, Stefano Vittorio ImpedovoClaudio Beretta, Antenore Giussani, Carlo Socci, Danilo Carlo Parolini, Massimo Abelli, Elena Ticozzelli, Umberto Baccarani, Gian Luigi Adani, Flavia Caputo, Barbara Buscemi, Mauro Frongia, Andrea Solinas, Salvatore Gruttadauria, Marco Spada, Antonio Daniele Pinna, Jacopo Romagnoli

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process. Methods. Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH,>50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome. Results. HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P<0.01) with single artery (83.1% versus 76.4%, P<0.05) compared with LOW-volume centres. Surgical technique correlated significantly with rate of donor right kidney and presence of multiple arteries: MINIOPEN (53% and 13%) versus HA-LAP (29% and 22%) versus FULL-LAP (11% and 23%), P<0.001 and P<0.05, respectively. All donors had an uneventful outcome; donor bleeding was more frequent in LOW-volume centres (4% versus 0.9%, P<0.05). Conclusions. Centre volume and surgical technique influenced donor kidney side selection. Donor nephrectomy in LOWvolume centres was associated with higher risk of donor bleeding.

Original languageEnglish
Pages (from-to)2126-2131
Number of pages6
JournalNephrology Dialysis Transplantation
Volume32
Issue number12
DOIs
Publication statusPublished - Dec 1 2017

Keywords

  • delayed graft function
  • donor outcome
  • living donor transplant
  • mini-invasive surgical approach
  • volume transplant centre

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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