[Living donor kidney transplant: the surgical procedure]

The ideal nephrectomy technique for living donors should preserve donor safety and maximize graft quality for the recipient. The laparoscopic technique performs as well as the traditional open technique and has become the procedure of choice in up to 70% of the transplant centers in the US. Since November 2001, 70 living donor kidney transplants have been performed at the Transplant Center of Padua: 42 of the donors underwent laparoscopic left nephrectomy, 28 standard open nephrectomy. Donor and recipient results were analyzed retrospectively. After a mean follow-up of 38+/-26 months (laparoscopic group) and 40+/-27 months (open nephrectomy group) no deaths had occurred among the donors. Only one minor surgical complication was registered (hernia at the port site in a laparoscopic donor). Renal function was optimal in both groups of recipients, without significant differences in the incidence of delayed graft function and acute rejection. Minimally invasive approaches to donor nephrectomy are as safe and effective as the traditional open technique, minimizing postoperative pain and disability, and providing a better cosmetic result.