**7. Conclusion**

Living donation is a success story that saved many patients with end-stage renal disease from dialysis and offered them a better quality of life and longer life expectancy. Donor surgery has shifted from the old open technique to a mini-invasive approach that offers less pain to this category of people who are not true patients but true heroes full of courage and nobility. Ensuring the safety and excellent long-term outcomes of these donors is our duty, through all steps from preoperative workup, surgery, and postoperative care.

Donors must be aware of all potential complications before acceptance and should feel free to resign at any moment. Complications of LLDN are present and must be prevented by entrusting them to highly qualified and experienced surgeons.

**37**

**Author details**

Maroun Moukarzel1

provided the original work is properly cited.

*Laparoscopic Live Donor Nephrectomy: Techniques and Results*

*DOI: http://dx.doi.org/10.5772/intechopen.80880*

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

1 Division of Urology and Kidney Transplantation, Hôtel Dieu de France University

2 Anesthesia and Intensive Care Department, Hôtel Dieu de France University

, Nabil Harake1

and Freda Richa2

\*, Charbel Chalouhy1

Hospital, Saint Joseph University Medical School, Beirut, Lebanon

Hospital, Saint Joseph University Medical School, Beirut, Lebanon

\*Address all correspondence to: marounmoukarzel@gmail.com

*Laparoscopic Live Donor Nephrectomy: Techniques and Results DOI: http://dx.doi.org/10.5772/intechopen.80880*

*Basic Principles and Practice in Surgery*

tion was 26 mL/min/1.73 m<sup>2</sup>

**7. Conclusion**

division or extensive mobilization of the left colon which may damage the neural plexus supplying the testis and may also disrupt lymphatic drainage [65]. Chylous leakage is a rare complication of LLDN. Prevention is assured by doing a meticulous and extensive clipping of lymphatic channels along the dissection area [52, 66]. Long-term complications are arterial hypertension, renal failure, and proteinuria, particularly in more high-risk donors, such as those with obesity, old or young donors, hypertensive donors, and those with kidney stones [67, 68]. Following kidney donation, there is a compensatory increase in function in the remaining kidney. By 3 months, remnant kidney clearance increases to a mean GFR of around 65–75% of predonation renal function [4]. The average decrease in GFR after dona-

disease (ESRD) in living kidney donors appears to be similar to or lower than that seen in the unselected general population despite a reduction in GFR [4, 24, 70]. The estimated lifetime risk of ESRD was 90 per 10,000 in donors, 326 per 10,000 in the general population, and 14 per 10,000 in matched healthy nondonor controls

Concerning hypertension, a large meta-analysis demonstrated that donors have an increased systolic blood pressure of 5 mmHg after 5–10 years from donation [73]. The rate of hypertension in donors was similar to that of the general population [74]. But it seems that there are no effects on kidney function and microalbuminuria at least in Caucasian population. Blacks and Hispanics may have higher

Finally, it is interesting to know that longevity of live donors remains greater

Living donation is a success story that saved many patients with end-stage renal disease from dialysis and offered them a better quality of life and longer life expectancy. Donor surgery has shifted from the old open technique to a mini-invasive approach that offers less pain to this category of people who are not true patients but true heroes full of courage and nobility. Ensuring the safety and excellent long-term outcomes of these donors is our duty, through all steps from preoperative

Donors must be aware of all potential complications before acceptance and should feel free to resign at any moment. Complications of LLDN are present and must be prevented by entrusting them to highly qualified and experienced surgeons.

[71]. Live donor nephrectomy alone will not lead to renal failure [72].

risks of hypertension-associated kidney disease after donation [75, 76].

compared to the general population [24, 72, 77].

workup, surgery, and postoperative care.

(range 8–50) [4, 69]. The incidence of end-stage renal

**36**
