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Rate of Major Complications Low With Living Donor Nephrectomy

Incidence of major complications after hand-assisted laparoscopic living donor nephrectomy low at 2.5 percent

FRIDAY, May 6, 2022 (HealthDay News) — The overall complication rate for hand-assisted laparoscopic living donor nephrectomy (HALLDN) was 12.4 percent, and most complications occurred after discharge, according to a study published online April 27 in Mayo Clinic Proceedings.

Xiomara Benavides, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues retrospectively categorized complications in 3,002 HALLDNs performed at a single center from Jan. 1, 2000, through Dec. 31, 2019. Correlates of complications before and after living donation were identified using modeling.

The researchers found no deaths related to the surgery. Major complications (intraoperative complications plus Clavien-Dindo grade ≥III postoperatively) had an incidence of 2.5 percent (74 complications). The overall complication rate was 12.4 percent (371 complications), including 15, 76, and 280 intraoperative, postoperative before discharge, and up to 120 days after discharge, respectively. Overall, 1.8 percent of patients required reoperation; all but one were incision-related problems. Of all complications, 76 percent occurred after discharge, including 85 percent of reoperations. No risk factor was identified for major complications. For any complication, risk factors included paramedian incision, a history of abdominopelvic surgery, male sex, non-White race (hazard ratios, 2.54, 1.37, 1.37, and 1.40, respectively), and early era of the experience.

“The results of this study are extremely reassuring for individuals who are considering being living kidney donors,” a coauthor said in a statement. “We found that this lifesaving surgery, when performed at experienced transplant centers, is extremely safe.”

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