Correlation of Surgical Times with Laparoscopic Live Donor Kidney Transplant Outcomes


Most studies revealed that ischemic time has substantial role in occurrence of delayed graft function (DGF) after deceased donor kidney transplantation. However, less is known about the potential impact of surgical times on early outcomes following live donor kidney transplantation. A retrospective cohort of 189 consecutive laparoscopic live donor kidney transplant (LDKT) recipients from January 2006 to August 2012 was analyzed to reveal the impact of pneumoperitoneum time (PT) and anastomosis time (AT) on donor and recipient length of hospital stay and early graft function (EGF). DGF was observed in 13 (6.8%) patients while slow graft function (SGF) was seen in 27 (14%) of the recipients. The median AT was 28 minutes (interquartile range 23, 35 minutes). AT was associated with DGF (Odds Ratio [OR] 1.044, per minute, 95% CI 1.007, 1.082, p = 0.018). Median recipient length of hospital stay was 8 (interquartile range 7, 11) days. Every 13.5 minutes of longer AT was associated with 1 extra day in hospital. The median PT was 180 minutes (interquartile range 144, 234 minutes). PT was associated with both DGF (OR 1.013 per minute, 95% CI 1.005, 1.021, p = 0.001) and SGF (OR 1.009 per minute, 95% CI 1.002, 1.016, p = 0.016). Every extra hour of PT was associated with 0.42 more days in hospital for the donor. Surgical times may be underestimated variables in dictating use of hospital resources. The effect of surgical times on long term hard outcomes entails further study.

Share and Cite:

Cimen, S. , Guler, S. , Alwayn, I. , Lawen, J. and Kiberd, B. (2013) Correlation of Surgical Times with Laparoscopic Live Donor Kidney Transplant Outcomes. Open Journal of Organ Transplant Surgery, 3, 68-72. doi: 10.4236/ojots.2013.34014.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] L. E. Ratner, L. J. Ciseck, R. G. Moore, F. G. Cigarroa, H. S. Kaufman and L. R. Kavoussi, “Laparoscopic Live Donor Nephrectomy,” Transplantation, Vol. 60, No. 9, 1995, pp. 1047-1049.
[2] T. L. Merlin, D. F. Scott, M. M. Rao, et al., “The Safety and Efficacy of Laparoscopic Live Donor Nephrectomy: A Systematic Review,” Transplantation, Vol. 70, No. 12, 2000, pp. 1659-1666.
[3] N. F. Kok, W. Weimar, I. P. Alwayn and J. N. Ijzermans, “The Current Practice of Live Donor Nephrectomy in Europe,” Transplantation, Vol. 82, No. 7, 2006, pp. 892-897.
[4] G. Akbulut, C. Polat, F. Aktepe, et al., “The Oxidative Effect of Prolonged CO2 Pneumoperitoneum on Renal Tissue of Rats,” Surgical Endoscopy, Vol. 18, No. 9, 2004, pp. 1384-1388.
[5] E. J. Hazebroek, R. W. de Bruin, N. D. Bouvy, et al., “Long-Term Impact of Pneumoperitoneum Used for Laparoscopic Donor Nephrectomy on Renal Function and Histomorphology in Donor and Recipient Rats,” Annals of Surgery, Vol. 237, No. 3, 2003, pp. 351-357.
[6] E. J. Hazebroek, R. W. de Bruin, N. D. Bouvy, et al., “Short-Term Impact of Carbon Dioxide, Helium and Gasless Laparoscopic Donor Nephrectomy on Renal Function and Histomorphology in Donor and Recipient,” Surgical Endoscopy, Vol. 16, No. 2, 2002, pp. 245-251.
[7] C. Troppmann, D. B. Ormond and R. V. Perez, “Laparo-scopic (vs Open) Live Donor Nephrectomy: A UNOS Database Analysis of Early Graft Function and Survival,” American Journal of Transplantation, Vol. 3, No. 10, 2003, pp. 1295-1301.
[8] J. M. Nogueira, C. B. Cangro, J. C. Fink, et al., “A Comparison of Recipient Renal Outcomes with Laparoscopic versus Open Live Donor Nephrectomy,” Transplantation, Vol. 67, No. 5, 1999, pp. 722-728.
[9] J. M. Nogueira, A. Haririan, S. C. Jacobs, et al., “The Detrimental Effect of Poor Early Graft Function after Laparoscopic Live Donor Nephrectomy on Graft Outcomes,” American Journal of Transplantation, Vol. 9, No. 2, 2009, pp. 337-347.
[10] T. V. Brennan, C. E. Freise, T. F. Fuller, A. Bostrom, S. J. Tomlanovich and S Feng, “Early Graft Function after Living Donor Kidney Transplantation Predicts Rejection But Not Outcomes,” American Journal of Transplantation, Vol. 4, No. 6, 2004, pp. 971-979.
[11] N. Smail, J. Tchervenkov, S. Paraskevas, et al., “Impact of Early Graft Function on 10 Year Graft Survival in Recipients of Kidneys from Standard or Expanded Criteria Donors,” Transplantation, Vol. 96, No. 2, 2013, pp. 176-181.
[12] A. Humar, E. M. Johnson, W. D. Payne, et al., “Effect of Initial Slow Graft Function on Renal Allograft Rejection and Survival,” Clinical Transplantation, Vol. 11, No. 6, 1997, pp. 623-627.
[13] K. Marzouk, J. Lawen, I. Alwayn and B. A. Kiberd, “The Impact of Vascular Anastomosis Time on Early Kidney Transplant Outcomes,” Transplantation Research, Vol. 2, No. 8, 2013.
[14] A. K. Sharma, S. L. Tolani, G. L. Rathi, P. Sharma, H. Gupta and R. Gupta, “Evaluation of Factors Causing Delayed Graft Function in Live Related Donor Renal Transplantation,” Saudi Journal of Kidney Diseases and Transplantation, Vol. 21, No. 2, 2010, pp. 242-245.
[15] J. Hellegering, J. Visser, H. J. Kloke, et al., “Deleterious Influence of Prolonged Warm Ischemia in Living Donor Kidney Transplantation,” Transplantation Proceedings, Vol. 44, No. 5, 2012, pp. 1222-1226.
[16] M. Tyson, E. Castle, P. Andrews, et al., “Early Graft Function after Laparoscopically Procured Living Donor Kidney Transplantation,” Journal of Urology, Vol. 184, No. 4, 2010, pp. 1434-1439.
[17] S. C. Abreu, D. A. Goldfarb, I. Derweesh, et al., “Factors Related to Delayed Graft Function after Laparoscopic Live Donor Nephrectomy,” Journal of Urology, Vol. 171 No. 1, 2004, pp. 52-57.
[18] W. Khoury, K. Jakowlev, A. Fein, H. Orenstein, R. Nakache and A. A. Weinbroum, “Renal Apoptosis Following Carbon Dioxide Pneumoperitoneum in a Rat Model,” Journal of Urology, Vol. 180, No. 4, 2008, pp. 1554-1558.
[19] L. E. Ratner, L. R. Kavoussi, P. G. Schulam, J. S. Bender, T. H. Magnuson and R. Montgomery, “Comparison of Laparoscopic Live Donor Nephrectomy versus the Standard Open Approach,” Transplantation Proceedings, Vol. 29, No. 1-2, 1997, pp. 138-139.
[20] E. M. Johnson, M. J. Remucal, K. J. Gillingham, R. A. Dahms, J. S. Najarian and A. J. Matas, “Complications and Risks of Living Donor Nephrectomy,” Transplantation, Vol. 64, No. 8, 1997, pp. 1124-1128.

Copyright © 2021 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.