To compare the effect of warm ischemia time and its significance, if any - open versus laparoscopic donor nephrectomy

Abstract

Introduction: The traditional open live-donor nephrectomy (OLDN) was intended to be replaced when the laparoscopic live-donor nephrectomy (LLDN) was introduced in 1995. The aim of the study is to analyze the effect of warm ischemia time (WIT) in open versus laparoscopic donor nephrectomy. Materials and Methods: The study included 200 consecutive donor transplants. Kidneys were retrieved by open donor nephrectomy vs. laparoscopic donor nephrectomy. We prospectively recorded the operative data, warm–cold ischemia time, graft function, hospital stay, return to work, and donor recovery. Results: A total of 200 participants were enrolled in the study dividing 100 per group in open and laparoscopic renal transplantation. The demographic data were comparable in both groups. The average WIT was 4.63 ± 1.4 min for the open group and 4.98 ± 1.82 min for the laparoscopic group (P < 0.05). In both groups, the average cold ischemia time was comparable. Both groups' postoperative urinary output, serum creatinine, and graft function exhibited no significant changes. Conclusion: The study demonstrates that varied degrees of WIT within the scope of this study have no negative impact on the outcomes of allografts obtained laparoscopically or openly. As a result, rushing renal artery ligation and division and kidney extraction to reduce WIT at the price of hurting the kidney transplant and donor are not realistic. However, it is uncertain how long the WIT safety window will stay open. This discovery may enable more urologists to undertake LLDN without the previously considered detrimental impact of WIT in compared to OLDN.

Keywords

• graft function
• laparoscopic live-donor nephrectomy
• live donor
• open live-donor nephrectomy
• warm ischemia time