Comparison of Outcomes of Hand-Assisted Laparoscopic to Open Nephrectomy for Pediatric Recipients

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Introduction: The purpose of this retrospective study is to compare the outcome of pediatric recipients of kidneys procured using a hand-assisted laparoscopic to open technique. Methods: Twenty-eight patients ≤ 18 years old who received kidneys procured by hand-assisted laparoscopic technique (HALDN group) were compared to seventeen patients who received kidneys procured using an open technique (ODN group) performed between 1998-2010. All patients were followed-up for at least 12 months post-transplant. Results: The eGFR for HALDN and ODN groups at discharge were 108.66 ± 37.23 and 106.1 ± 50.55 ml/min/1.73m2 (p = 0.845), respectively. The eGFR for HALDN and ODN groups at 6 and 12 months were 97.77 ± 28.25 and 81.73 ± 27.46 ml/min/1.73m2, and 94.56 ± 28.3 and 85.74 ± 30.1 ml/min/1.73m2 (p = 0.085, p = 0.344), respectively. The serum creatinine for HALDN and ODN groups at discharge were 0.93 ± 0.48 and 0.94 ± 0.54 mg/dL (p = 0.917), respectively. The serum creatinine for HALDN and ODN groups at 6 and 12 months were 1.01 ± 0.44 and 1.11 ± 0.55 mg/dL, and 1.04 ± 0.52 and 1.14 ± 0.46 mg/dL (p = 0.516, p = 0.554), respectively. There was 1 episode of DGF in the HALDN group and none in the ODN group. The incidence of early allograft rejection (AR) was 10.7% and 5.9% in the HALDN and ODN groups (p = 0.479), respectively. The incidence of late AR was 7.1% and 11.8% in the HALDN and ODN groups (p = 0.574), respectively. There were no cases of DGF, early AR, or late AR in any of the recipients aged 0-5 years old. The patient and graft survival for both groups were 100 % at 6 and 12 months post-transplant. Conclusion: The short-term outcome of recipients of kidneys procured via HALDN is comparable to that of kidneys procured via ODN in pediatric patients.Table: [Allograft Data]Figure: [Post-transplant eGFR]

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.