Emerging tobacco hazards in China

Surgical techniques should be fully evaluatedEditor-The editorial by Nicholson and Bradley on renal transplantation from living donors rightly pointed out that the United Kingdom has a lower rate of transplantations which use kidneys from living donors than the United States or Norway. 1 The recent report by the Royal College of Surgeons on organ transplantation in the United Kingdom recommended that steps should be taken to increase the use of kidneys from living donors in the United Kingdom to offset the shortage of cadaveric kidneys as well as to improve outcome. 2 In the United Kingdom in 1998, 38% more transplantations were performed using organs from living donors than in 1997.However, there is still some way to go if a level similar to that of the United States or Scandinavia (25-30%) is to be achieved.Nicholson and Bradley identify the risks associated with donor nephrectomy and state that much of the morbidity that occurs after open nephrectomy is related to the wound.For this reason they believe that the use of laparoscopically assisted donor nephrectomy needs to be examined in the light of the experience of, for example, the Johns Hopkins Hospital in Baltimore, Maryland.However, there have been no randomised prospective trials of this procedure, which takes longer than open nephrectomy.Furthermore, all of the non-randomised comparisons have been of open nephrectomy performed through a loin incision, with or without removal of a rib.If an anterior