Donor and Recipient Outcomes of Retroperitoneal Laparoscopic Donor Nephrectomy in Obese Versus Nonobese Donors: A Prospective Study

Introduction. Obese donors are increasingly accepted for living kidney donation. Obese individuals benefit the most from minimal access surgery; however, laparoscopic donor nephrectomy may be technically challenging in these individuals. Retroperitoneal laparoscopic donor nephrectomy (RLDN) in particular may be hampered by excessive perinephric fat. We performed a prospective nonrandomized controlled study comparing outcomes of RLDN in obese and nonobese kidney donors. Aim. To compare operative parameters, donor complications, and recipient outcomes in RLDN performed in obese and nonobese donors. Materials and Methods. From June 2014 to April 2016, 200 donors underwent RLDN. Of these, 160 were nonobese (group I), and 40 were obese (group II). Preoperative parameters including body mass index, age, and sex, and operative parameters including total operative time, warm ischemia time, and estimated blood loss were recorded. Complications were compared using the Clavien-Dindo classification. Recipients' serum creatinine at day 7, 15, and 30 was compared between recipients who received grafts from obese and nonobese donors. Results. There were 17.5% right-sided donors in group I and 15% in group II. Operative time, warm ischemia time, blood loss, length of hospital stay, and complications were similar in the 2 groups, and there were no statistically significant differences. Serum creatinine in the recipients was similar on follow-up. Conclusions. RLDN is safe and efficacious in obese donors. It gives all the benefits of minimal-access surgery without compromising on recipient outcomes.