A. Hamza, M. Tajjour, R. Eidner, H. Loertzer, A. Jurczok, K. Fischer, P. Fornara

Abstract

The concern of this study was to verify whether the lower invasivity can be proved in the laparoscopic hand-assisted compared with the open Donor-nephrectomy with the help of well-chosen parameters. Furthermore it should be examined whether the choice of the operation method has an influence on the function of the remaining kidney of the donator.

We selected 46 patients who donated a kidney to partner or relative. We have grouped these patients in two groups according to the applied surgical technique (open or hand-assisted laparoscopic Nephrectomy).

Data collection took place retrospectively in 14 patients from 46 included in the study (5 men, 9 women, middle age 49 years) with which a laparoscopic hand-assisted Donor-nephrectomy was carried out in the period between December, 2004 and November, 2006. 32 patients (12 men, 20 women, middle age 52 years) served as comparative group. The measurement of the acute phase Parameters included C-reactive protein (CRP) and serum Amyloid A (SAA) as well as the biochemical markers of the Glomerular filtration rate (GFR) serum creatinin and serum Cystatin C after different periods.

Generally, both surgical techniques (open and laparoskopische hand-assisted-Donornephrektomie) are invasive for the donor’s body, the differences in CRP and SAA-concentrations appeared significant during the 1. post surgical day to the advantage of the open Donor-nephrectomy. 3 days after the live donation a significant difference existed in favour of the laparoscopic hand-assisted Donor-nephrectomy. At all other measuring times no significant difference could be found between both patients’ groups. The investigation of the nephritic function parameters Creatinin and Cystatin C showed an increase of the serum concentration after the live-donation in both groups. In the comparison of both patient’s groups with regard to Creatinin and Cystatin C concentrations, no significant difference could be proved at all measuring times between open and laparoscopic hand-assisted Donor-nephrectomy.

Key words: nephritic transplant, living donation, donor nephrectomy

Dr. Amir Hamza

Universitätsklinik und Poliklinik für Urologie

Martin-Luther-Universität

Halle-Wittenberg

Nierentransplantationszentrum

Ernst-Grube-Str. 40

06120 Halle

E-Mail: amir.hamza@bitte-keinen-spammedizin.uni-halle.de