Left Versus Right: Side Doesn't Matter In Laparoscopic Donor Nephrectomy For Renal Transplantation

Main Category: Urology / Nephrology
Also Included In: Transplants / Organ Donations
Article Date: 06 Nov 2006 - 0:00 PDT

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UroToday.com - Traditionally, donor nephrectomy specimens have been harvested from the left side, due to a variety of technical considerations, not the least of which is the fact that the vessels to the kidney are considerably longer on the left and subsequent vascular anastomoses in the recipient are facilitated. With the development of laparoscopic approaches, the left continues to be the favored side for harvest, even when the left kidney may be the better functioning of the two. Can the right kidney be routinely used for transplant nephrectomy? Here Liu and colleagues examine the differences in outcome between left and right laparoscopic transplant nephrectomy.

Over a 3 year period, 25 donor laparoscopic donor nephrectomies were performed, 6 of which were from the right side. The authors noted no difference in operative time, warm ischemia time, or length of stay between right and left nephrectomy patients. Changes in donor creatinine and creatinine clearance after nephrectomy were similar between the two groups. Five patients in the left sided group required transient dialysis whereas no one in the right sided group required it. In follow-up, graft function, as assessed by serial creatinine levels and creatinine clearance, were no different between the two groups.

This report suggests that the right kidney can be effectively utilized for donor nephrectomy with no significant difference in morbidity or outcome. The authors suggest that renal function rather than anatomy should guide the choice of which kidney to harvest from the donor, leaving the better functioning kidney in place.

Reviewed by UroToday.com Contributing Editor Christopher G. Wood, MD, FACS

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