Tag Archives: transplant

PUBLISHED: Robotic-Assisted Laparoscopic Left Donor Nephrectomy for Living Kidney Donation

Robotic-Assisted Laparoscopic Left Donor Nephrectomy for Living Kidney Donation
Srilakshmi Atthota, MBBS; Jessica Grasso, PA-C; Leigh Anne Dageforde, MD, MPH
Massachusetts General Hospital

Kidney transplantation is the preferred treatment for patients with end-stage renal disease and is associated with a better quality of life and survival compared to other renal replacement therapies. Compared to deceased donor kidneys, living donor kidney donation is associated with shorter wait times, improved patient and graft survival, and the possibility of preemptive transplantation.

After the initial learning curve, robotic-assisted living donor nephrectomy has similar outcomes compared to open and laparoscopic nephrectomy, and in some settings an overall decreased length of stay. This article presents the case of a robotic-assisted living donor nephrectomy, including evaluation, technique, and considerations for the surgeon preoperatively and intraoperatively.

PUBLISHED: Left Laparoscopic Donor Nephrectomy

Left Laparoscopic Donor Nephrectomy
Shoko Kimura, MDTatsuo Kawai, MD
Massachusetts General Hospital

Over the past decade, laparoscopic donor nephrectomy has gradually replaced the conventional open approach and has become the standard of care in living donor kidney transplantations. Compared to open nephrectomy, laparoscopic nephrectomy reduces postoperative pain, shortens the length of hospital stay, and improves the cosmetic outcome. This article illustrates the author’s technique of pure laparoscopic donor nephrectomy.

PUBLISHED: Recipient Kidney Transplant from a Living Donor

Recipient Kidney Transplant from a Living Donor
Maggie L. Westfal, MD, MPHNahel Elias, MD, FACS
Massachusetts General Hospital

End stage renal disease (ESRD) is the final stage in the progression of chronic kidney disease (CKD). CKD has a multitude of etiologies, presents in a variety of ways, and progresses in a patient-dependent manner. Despite the heterogeneity of CKD, once ESRD ensues, patients require Renal Replacement Therapy (RRT). RRT is one of three prongs: hemodialysis, peritoneal dialysis, or kidney transplant.

Of these, kidney transplantation provides the patient with the best quality of life, an improved survival, and an opportunity for cure. However, the success of kidney transplantation with improved outcomes and tolerance to the required immunosuppression has led to an extreme organ shortage despite the increase in deceased organ donors. As a result, the push for living donors has become increasingly more important.

For recipients, the best outcomes are with transplants from a living donor due to superior graft quality and elimination of the need for waiting and dialysis. This article will present such a case and discuss the important considerations a physician must make preoperatively and intraoperatively when performing kidney transplantations.