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| |  Surgical Technique Used in Living Donors Has Limited Impact 4 Years After Kidney Donation: Presented at ATC By Cheryl Lathrop BOSTON -- June 4, 2009 -- The long-term outcome of live kidney donation is excellent from the perspective of both the donor and the recipient. At long-term follow-up, the surgical technique has only a limited impact on quality of life (QOL) and fatigue, according to a study presented here at the 2009 American Transplant Congress (ATC). Leonienke F. C. Dols, MD, Department of Surgery, Erasmus MC, Rotterdam, the Netherlands, presented the findings here on June 2. One-year results after mini-incision donor nephrectomy (MIDN) versus laparoscopic donor nephrectomy (LDN) showed a benefit with LDN including better QOL and fatigue scores. However, the long-term outcome of both surgical techniques, physical and psychosocial effects, was ill defined. Therefore, Dr. Dols and colleagues evaluated the long-term outcomes of a multicentre, prospective, randomised, single-blind, living donor (LiDo) trial comparing LDN with MIDN in 100 kidney donors at the University Medical Centers in Rotterdam and Nijmegen. Its primary endpoint was physical fatigue. Follow-up data of the kidney donors, who had been randomly assigned to either MIDN or LDN surgical techniques in the LiDo trial, were prospectively collected. Data included blood pressure, estimated glomerular filtration rate (eGFR), body image, quality of life, fatigue, and graft function. Subjective experience of donation was examined using a short questionnaire. After a median follow-up of 4 years, clinical and laboratory data and QOL data was available for most patients in each group. After 4 years follow-up, mean eGFR did not significantly differ between MIDN and LDN (75 vs 76 mL/min, P = .39). A total of 4 donors (3 MIDN, 1 LDN; P = .62) developed hypertension that could be adequately controlled medically. In contrast to follow-up after 1 year where LDN showed a benefit, most dimensions of QOL and fatigue showed no difference between the 2 groups at long-term follow-up. Body image scores did not differ between groups. Regardless of operation technique, all donors said they would donate again if possible. Importantly, graft failure and patient survival was similar for MIDN and LDN (8% vs 6%, and 90% vs 94% respectively). [Presentation title: Long-Term Follow-Up of a Randomized Trial Comparing Laparoscopic and Mini-Incision Open Donor Nephrectomy. Abstract 421]
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