Mansour AM, et al. - The efficacy of laparoscopic donor nephrectomy (LDN) was compared with open donor nephrectomy (ODN) within a specified Enhanced Recovery Program (ERP) for left kidney donations. Outcomes displayed that LDN offered less general and physical fatigue and better physical function at 6 weeks postoperatively when compared to open surgery for left kidney donations.

Methods

• This trial was conducted between January 2013 and June 2015.
• Eligible left side donors were randomized to laparoscopic or open donor nephrectomy in a 1:1 ratio with recovery optimized within a standardized ERP.
• The patient-reported measure of physical fatigue, as measured by the physical fatigue domain of the translated Multidimensional Fatigue Inventory 20 (MFI-20) was considered as the primary outcome.
• Other donor recovery outcomes, postoperative pain scores, hospital stay, perioperative complications and graft outcomes were included in the secondary outcomes.

Results

• 224 donors (laparoscopy, n=113; open surgery, n=111) were randomly allocated.
• 6 weeks postoperatively, physical fatigue domain scores in MFI-20 were significantly lower in the LDN group (mean: laparoscopy, 8.2 ± 3.2 vs. open surgery, 13.05± 2.9) (p=0.007).
• In the LDN group, median total hospital stay was also significantly shorter (median: laparoscopy, 2; interquartile range [IQR], 1 to 5 vs. open surgery, 4; IQR, 2 to 9 days) (P = 0.002).
• LDN was associated with less pain scores and less non-opioid analgesic requirements. 
• In both groups, warm ischemia times were not significantly different (mean: laparoscopy, 2.5 ± 0.8 vs. open surgery, 2.2 ± 0.6) (p=0.431).