Key result
Implementation of hand-assisted retroperitoneoscopic donor nephrectomy increased the utilization of right kidneys from 6.1% to an average of 19.6% annually.
Why the study?
Laparoscopic donor nephrectomy caused a shift toward left donor nephrectomy with low rates of endoscopic right donor nephrectomy, leading to the introduction of HARP-DN to avoid intra-abdominal complications and provide technical advantages for right-sided procedures.
Does hand-assisted retroperitoneoscopic donor nephrectomy increase the utilization of right kidneys in living donor kidney transplantation?
Observational (n=565)
No
Does hand-assisted retroperitoneoscopic donor nephrectomy increase the utilization of right kidneys in living donor kidney transplantation?
Absolute Event Rate: 19.6% vs 6.1%
The implementation of hand-assisted retroperitoneoscopic donor nephrectomy significantly increases the utilization of right kidneys for living donor kidney transplantation without increasing intra-abdominal complications.
HARP-DN may facilitate right donor nephrectomy; leaves open whether it reduces complications versus standard laparoscopy.
The introduction of laparoscopic donor nephrectomy caused a shift toward' left donor nephrectomy. Some centers report a significantly low rate of endoscopic right donor nephrectomy. Hand-assisted retroperitoneoscopic donor nephrectomy (HARP-DN) was introduced as a novel surgical technique, which aims to avoid intra-abdominal complications. It was also reported to provide technical advantages for right-sided DN. In this retrospective single-center study, we evaluated the impact of HARP-DN technique on utilization of right-sided DNs. After the implementation of HARP-DN on February 2009, a total of 565 DNs were performed until December 2015. The introduction of HARP-DN technique resulted in an immediate increase in the utilization of right kidneys from 6.1% to an average of 19.6% annually. The donors 'outcome was similar to the left-sided and right-sided DN groups, excluding the increased incidence of incisional hernias in left kidney donors. None of the donors developed intra-abdominal complications. In conclusion, the implementation of HARP technique significantly increased the use of right-sided DNs, which enables a more liberal use of donors in LDKT.
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Akın et al. (2020) conducted an observational in Donor nephrectomy (n=565). Hand-assisted retroperitoneoscopic donor nephrectomy (HARP-DN) vs. Pre-implementation standard was evaluated on Utilization of right kidneys. Implementation of hand-assisted retroperitoneoscopic donor nephrectomy increased the utilization of right kidneys from 6.1% to an average of 19.6% annually.
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