Section 3 Clinical Surgery

*Basic Principles and Practice in Surgery*

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**20**

**23**

**Chapter 3**

Results

*and Freda Richa*

living kidney donation

**1. Introduction**

**Abstract**

Laparoscopic Live Donor

Nephrectomy: Techniques and

*Maroun Moukarzel, Charbel Chalouhy, Nabil Harake*

year to maintain adequate experience and offer less complication rate.

**Keywords:** live donor, laparoscopy, nephrectomy, kidney transplantation,

Living kidney donation has successfully improved the lives of many patients worldwide for over half a century. Do we still have the same need for living donors in 2018? The answer is obviously yes and for many reasons. The first is organ shortage with a widening gap between renal supply and demand in all countries that increases every year despite the use of marginal deceased donors. Waiting lists are growing everywhere. The site of the US Government Information on Organ Donation and Transplantation, organdonor.gov, shows recently a transplant waiting list of more than 114,000 patients of whom 83% are potential kidney recipients [1]. The second reason is the significant graft survival advantage and the reduction of the waiting time between end-stage renal disease and graft implantation. The results of renal transplantation from living donors are better compared to those from cadaveric kidneys with a graft half-life of 18 versus

Living donation is still needed to overcome organ shortage. All countries seem to increase and encourage such kind of donation according to medical and ethical guidelines. The results of renal transplantation from living donors are better compared to those from cadaveric kidneys. Since the first successful kidney transplantation from a living donor, some 63 years ago, surgery has shifted toward a less invasive approach offering to the donor less pain, better cosmesis, a shorter hospital stay, and a quick return to normal activities. Laparoscopic living-donor nephrectomy (LLDN) is now considered as the gold standard approach for kidney retrieval on live donors and has undoubtedly revolutionized kidney donation. It must offer to the donor safety, low morbidity, and fast recovery and must obtain a graft with adequate vessel length, short warm ischemia time, and well-preserved ureteral blood supply. We describe our technique of LLDN according to safety principles and reproducible steps. Highly qualified and well-trained surgeons are allowed to perform such techniques within a very well-equipped environment and with experienced surgical staff. A living donor program should undertake at least 30 cases per
