Category: Laparoscopic/ Robotic: Other

MP17-16 - Retroperitoneal laparoscopic donor nephrectomy is safe and suitable for both donor and recipient even though the graft has multiple arteries.

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

 It is considered that laparoscopic donor nephrectomy is a gold standard procedure for live kidney transplantation even if the graft has multiple renal arteries or donor is overweight. In addition, nowadays, we can choose new methods of laparoscopic procedures including single site port surgery. We consistently perform conventional retroperitoneal laparoscopic donor nephrectomy from 2001. The aim of this study is to examine the safety and efficacy of our method, and to clarify the usefulness of this laparoscopic procedure.


Methods :

From September 2001 to March 2018, 298 retroperitoneal laparoscopic live donor nephrectomies were performed at Osaka University Hospital. In this study, the cases of intraperitoneal laparoscopic procedures were excluded. We examined demographics, the risk of slow and delayed graft function, the incidence of intra- and post-surgical complications, post-transplant hypertension, acute graft rejection, mean serum creatinine level, and patient and graft survival.


Results :

The average age of donor was 58.5 years old and male/female ratio was 105/193. The average of body mass index was 22.9, and 68 donors were smoker or ex-smoker. The number of right nephrectomy was 46 cases. Operation time was 217.5minutes and average blood loss was 103.3ml. Comparing to the cases from 2001 to 2009, these data of donors after 2010 were improved. In all cases, 24.2% of grafts had multiple renal arteries. Even though the grafts had multiple renal arteries, the graft functions after kidney transplantations were in good condition comparing to the grafts which had a single renal artery. The rate of adverse events with this procedure is low (abdominal wall scar hernia; 3 cases, blood loss over 500ml; 6 cases). In 7 cases, there were slow graft functions after kidney transplantations. These cases having adverse events were received donor nephrectomy in early period (2001-2009).


Conclusions :

 Comparing to single site port surgery, conventional retroperitoneal laparoscopic donor nephrectomy may be inferior at the point of scar, but our method is safer than other laparoscopic procedures.

Ryoichi Imamura

Associate Professor
Department of Urology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan

Current Position:
Associate Professor,
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
2-2 Yamadaoka Suita Osaka, 565-0871, Japan
Tel: +81-6-6879-3531
Fax: +81-6-6879-3539
Email: imamura@uro.med.osaka-u.ac.jp

Medical School:
1996 M.D: Nara Medical University, Nara, Japan
2007 Ph.D.: Osaka University Graduate School of Medicine, Osaka, Japan

Training and Experience:
1996 Resident, Dept. of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases
1998 Resident, Dept. of Urology, Osaka Rosai Hospital
1999 Clinical fellow, Dept. of Urology, Osaka Seamen’s Hospital
2007 Clinical fellow, Dept of Urology, Osaka University Graduate School of Medicine
2007 Research Fellow, Dept. of Nephrology, Indiana University School of Medicine, Indianapolis, IN
2008 Assistant Medical Director, Dept. of Urology, Osaka Police Hospital
2009 Medical Director, Dept. of Urology, Osaka Police Hospital
2010 Medical Director, Dept. of Urology, Osaka General Medical Center
2013 Assistant Chief Medical Director, Dept. of Urology, Osaka General Medical Center
2014 Assistant Professor, Dept. of Urology, Osaka University Graduate School of Medicine

Toyofumi Abe

Department of Urology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan

Taigo Kato

Suita, Osaka, Japan

Masataka Kawamura

Suita, Osaka, Japan

Shigeaki Nakazawa

Suita, Osaka, Japan

Akira Nagahara

Assistant Professor
Department of Urology, Osaka University Graduate School of Medicine
Suita, Osaka, Japan

Naotsugu Ichimaru

Suita, Osaka, Japan

Norio Nonomura

Suita, Osaka, Japan