Living Donor Nephrectomy: Analysis of Trends and Outcomes From a Contemporary National Dataset. in Urology / Urology. 2024 Sep 18:S0090-4295(24)00808-2. doi: 10.1016/j.urology.2024.09.020.

2024
AOU San Luigi di Orbassano

Tipo pubblicazione

Journal Article

Autori/Collaboratori (12)Vedi tutti...

Lasorsa F
Department of Urology, Rush University, Chicago, IL; Department of Precision and Regenerative Medicine and Ionian Area-Urology, Andrology and Kidney Transplantation Unit, University of Bari "Aldo Moro", Bari, Italy.
Orsini A
Department of Urology, Rush University, Chicago, IL; Urology Unit, Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy.
Bignante G
Department of Urology, Rush University, Chicago, IL; Division of Urology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.

et alii...

Abstract

OBJECTIVE: To analyze the temporal trends and perioperative and long-term outcomes of living donor kidney nephrectomy in the United States. METHODS: The PearlDiverTM Mariner database (Pearl-Diver Technologies, Colorado Springs, CO, USA) was used for our retrospective analysis. The data were identified using ICD-9/10 codes, as well as CPT codes. Continuous and categorical variables were compared using 2-sided tests. Multivariate logistic regression analysis was conducted to identify predictors of 5-year ESRD. RESULTS: A total of 6333 patients were identified (median age 54, IQR 46-62 years) from 2010 to April 2022. A greater percentage of living donor nephrectomies were performed by general surgeons (56.1%), followed by transplant surgeons (16.5%) and urologists (14.7%). Unfortunately, physician specialty was not reported for the remaining patients. The MIS exceeded open surgery in each specialty group and inpatient setting. The significant predictors of ESRD were male, preoperative DM and hypertension, tobacco smoking, perioperative AKI and younger age at the time of kidney donation. CONCLUSION: MIS represents the main surgical approach for organ procurement. A meticulous selection process for donors and subsequent close monitoring are necessary to minimize the putative consequences of donor nephrectomy.

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PMID : 39304069

DOI : 10.1016/j.urology.2024.09.020