Published 2014-07-03
Chaidir Arif Mochtar Irfan Wahyudi Bagus Baskoro


Objective: To evaluate and analyze variables related to the surgical and direct post-operative outcomes of our initial experience of laparoscopic living donor nephrectomies (LLDN). Material & methods: This retrospective analysis describes the first 10 laparoscopic nephrectomies in living donors performed in Cipto Mangunkusumo Hospital. All surgeries were performed by the same surgical team. Variables related to the surgical and post-operative outcome and complications in donors were evaluated and analyzed.Results: The average age of the donors was 31.8 years with male : female ratio of 7 : 3. Thirty percent of them were family related to the recipient. The left kidney was extracted from all patients and multiple renal vessels were found in one cases. The mean operation time was 321.9 ± 27 min, first warm ischemia time was 9.37 ± 3.34 min and estimated blood loss was 270 ± 182.87ml. The hospital stay was 4.1 ± 1.3 days, VAS in the first day post surgery was 3 ± 1 with epidural analgesia needed for 1.8 ± 0.6 days, and drain was kept in for 2.8 ± 1.2 days while urethral cathether for 2.4 ± 1.2. Time to return to work was 16 ± 8.4 days. Conclusion: LLDN results in acceptable blood loss,less post-operative pain, short hospital stay and short time to return to work for the donors, therefore promising to be the gold standard among living donor nephrectomy surgical options.Keywords: Laparoscopic living donor nephrectomy,renal transplantation, Indonesia.



Tan HP, Orloff M, Marcos A, Mieles L, Kavoussi LR, Ratner LE. Laparoscopic live-donor nephrectomy: Development of a new standard in renal transplantation. Graft. 2002; 5: 405.

Su LM, Ratner LE, Montgomery RA, Jarret TW, Trock BJ, Sinkov V, et al. Laparoscopic live donor nephrectoy: Trends in donor and recipient mordibity following 381 consecutive cases. Annals of Surgery.2004; 240: 358-63.

Giessing M. Laparoscopic living-donor nephrectomy. Nephrol Dial Transplant. 2004; 19[Suppl 4]: iv36-iv40.

Challacombe B, Mamode N. Laparoscopic live donor nephrectomy. Nephrol Dial Transplant. 2004; 19: 2961-4.

Flowers JL, Jacobs S, Cho F, Morton A, Rosenberger WF, Evans D, et al. Comparison of open and laparoscopic live donor nephrectomy. Ann Surg. 1997; 226: 483-90.

Minnee RC, Idu MM. A review of laparoscopic donor nephrectomy. Neth J Med. 2010; 68(5): 199-206.

Kim BS, Yoo ES, Kim TH, Kwon TG. Renal function recovery in donors and recipients after live donor nephrectomy: Hand-assisted laparoscopic vs. open procedure. Korean J Urol. 2010; 51: 245-49

Situmorang GR, Taher TR, Wahyudi I. Renal transplantation in Jakarta - Four decades of experience. 15th Congress of the European Society for Organ Transplantation, 4-7 September 2011.

Minnee RC, Bemelman WA, Polle SW. Older living kidney donors: surgical outcome and quality of life. Transplantation. 2008; 86(2): 251-6.

Boorjian S, Munver R, Sosa RE, Del Pizzo JJ. Right laparoscopic live donor nephrectomy: A singel institution experience. Transplantation. 2004; 77: 437-40.

Ratner LE, Montgomery RA, Kavoussi LR. Laparoscopic live donor nephrectomy: The four years Johns Hopkins University experience. Nephrol Dial Transplant. 1999; 14: 2090-3.

Roza AM, Perloff LJ, Naji A, Grossman RA, Barker CF. Living-related donors with bilateral multiple renal arteries. A twenty-year experience. Transplantation. 1989; 47(2): 397-9.

Genc V, Karaca AS, Orozakunov E, Cakmak A, Sevim Y, Ustuner E, et al. Multiple renal arteries challenge in laparoscopic donor nephrectomy: How far can we? JKSS; 2010.

Kok NF, Dols LF, Hunink MG, Alwayn IP, Tran KT, Weimar W. Complex vascular anatomy in live kidney donation: Imaging and consequences for clinical outcome. Transplantation. 2008; 85(12): 1760-5.

Minnee RC, Surachno S, Bemelman F. Impact of additional vascular reconstructions on survival of kidney transplants. Int. Surg. 2008; 93(2): 111-5.

Copyright Information
Department of Urology, Faculty of Medicine/Airlangga University