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Laparoscopic Live-Donor Nephrectomy: Development of a New Standard in Renal Transplantation

Mark Orloff

Amadeo Marcos

Luis Mieles

Louis R. Kavoussi

Lloyd E. Ratner

There continues to be a growing disparity between organ supply and demand. Becausethe supply of cadaver kidneys has remained relatively fixed, alternative sources of organs,including ways to increase live organs, have been sought. In February 1995, Ratnerand colleagues performed the first successful laparoscopic live-donor nephrectomy(LLDN). Since then, the authors and others have noted an increase in live-kidney donation.It has been shown that LLDN offers the donors shorter recuperative time, less post-operativepain, improved cosmesis, similar hospital costs, and currently similar or lessmorbidity compared to open nephrectomy. The reduction in donor financial burden post-operativelyas a result of earlier return to work is another incentive for the donors. In addition,it has been shown that the recipients have at least similar patient and graft survivalrates, short- and long-term renal functions, frequency and severity of rejectionepisodes, need for dialysis, costs, and readmission rates compared to recipients withkidneys procured from the standard open-nephrectomy operation. The authors concludethat LLDN should be the standard practice for live kidney donors.

Key Words: laparoscopic • live donor • nephrectomy • renal transplantation

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