Anesthesiological care for donor nephrectomy and possibilities of its optimization

Background. Living related donor (LRD) kidney transplantation is the most effective strategy of renal replacement therapy for patients with stage 5 chronic kidney disease. LRD organs are used due to the shortage of organs from deceased donors. One of the key problems still remained is the anesthetic management of laparoscopic donor nephrectomy (LDNE) and its impact on the graft condition. Objective. Analysis and generalization of the results obtained in the studies of anesthetic management of LDNE and its impact on the graft condition. Material and methods. The literature search was performed in the PubMed, eLibrary, The Cochrane Library, MedLine, EMBASE databases using the search queries: "laparoscopic donor nephrectomy", "nephrectomy", "anesthesia for donor nephrectomy and kidney transplantation", "renal graft condition during anesthesia", which made it possible to find and analyze 445 works published in foreign and Russian journals from 2020 to 2025. As a result of the selection, 51 publications were included in the review, including 10 randomized clinical trials, 1 experimental study, 16 observational studies, 2 meta-analyses, 10 systematic reviews, 1 single-center retrospective controlled study, 5 single-center prospective controlled studies, 4 clinical guidelines, 2 clinical case reports. Conclusion. In the world literature over the recent five years, we have hardly found a large number of reports covering the issue of perioperative anesthetic management of LDNE. The available data indicate that general, combined and regional anesthesia are of interest and can be effectively used in LDNE.