344 PROSPECTIVE NON-RANDOMIZED COMPARISON BETWEEN RIGHT-AND LEFT-SIDED HAND-ASSISTED LAPAROSCOPIC DONOR NEPHRECTOMY

Background. Despite technical improvements, laparoscopic living donor right nephrectomy can be associated with difficulties to obtain a sufficient lengths of right renal vessels. We report our experience with right-sided, hand-assisted, laparoscopic donor nephrectomy (HALDN). Patients and methods. During a 7-year period (2003‐2010), right HALDN was performed on 51 and left HALDN on 40 living kidney donors. We prospectively collected perioperative outcome data in donors and recipients including graft function and calculated 1-year graft survival according to the Kaplan-Meier-method. Results. There were no conversions. The mean procedure time was 123 minutes versus 135 minutes for left HALDN (P .09). Mean blood loss was 92 mL versus 101 mL in left HALDN (P .09). There was no renal artery or vein thrombosis. The mean warm ischemia time was 47 seconds versus 41 seconds in left HALDN (P .21). Hospital discharge was on an average at 3.4 days postoperatively. Delayed graft function occurred in two recipients: one in the left group and the other in the right group. Further, no significant difference in serum creatinine values was seen between the groups at 1 year after the transplantation. One-year graft survival rate was 97.5% in the left versus 98.1% in the right group. Conclusion. Right HALDN is as safe and feasible as left HALDN. Hand-assistance results in a convenient length of right renal vessels without an increased incidence of vascular thrombosis.