Pediatric recipients of adult laparoscopic donor nephrectomy: A single-institution outcome analysis - Abstract

Introduction: For more than a decade, adult laparoscopic donor nephrectomy (LDN) has been offered as a minimally invasive organ procurement modality for pediatric patients with end-stage renal disease.

There is a paucity of literature reflecting pediatric recipient outcomes of adult LDN kidneys, and the objective of this study was to evaluate our institutional experience.

Methods: Thirty-six pediatric patients were identified as recipients of adult LDN from 2000 to 2009 at our institution.

Results: The most common renal disease was dysplasia (N = 6) for those 0 to 5 years of age and nephronophthisis (N = 7) for those 6 to 18 years if age. The mean operative time for those 0 to 5 years of age was 262 ± 38 min and 216 ± 69 min for those 6 to 18 years (P < 0.04). Perioperative complications were more common in those 0 to 5 years of age (73 vs 24%, P < 0.01) and the length of stay (19.3 ± 20.8 days vs 4.8 ± 2.7 days, P < 0.001) was longer compared with those 6 to 18 years.

Conclusion: Pediatric recipients of adult LDN kidneys present unique surgical and hemodynamic challenges. Although renal transplants in pediatric patients are associated with postoperative morbidity, graft survival is comparable to adult LDN recipients.

KEYWORDS: Pediatric, laparoscopic donor nephrectomy, adult kidney donor, outcomes

CORRESPONDENCE: Ronald S. Chamberlain, MD, MPA, FACS, Chairman and Surgeon-in-Chief, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, New Jersey 07039 USA ( )

CITATION: UroToday Int J. 2013 February;6(1):art 7.

DOIhttp://dx.doi.org/10.3834/uij.1944-5784.2013.02.07